Health Services

Online Medical Forms

Upon acceptance to WCSU all incoming students (full-time, part-time, graduate & international) are required to submit a Connecticut State University Student Health Services Form, which includes the Immunization Requirements. 

  Connecticut State University Student Health Services Form (Required) C.S.U. Health form 2023

    • a.  Please download the form above or detach from your “Arrive in 5” packet
    • b.  Fill out page 2 of the form ( medical history/emergency contact etc)
    • c.  Have your medical provider fill out and sign page 1 (immunization record)
      • OR attach printed immunization list and TB risk assessment
    • d.  Student (and parent if student is under 18 years old) sign bottom of page 1
    • When completed, form should be uploaded to the Medicat Patient Portal 


Other Health Services Forms (less common):

  • Medical Immunization Exemption Form
  • Immunization Records Release Form
  •  “Religious”/Non-Medical Exemptions: In accordance with Public Act 21-6, WCSU is not accepting any new Exemptions on the basis of religion.  If you have received an exemption dated and verified prior to April 27th, 2021 you may submit it for review to or fax to (203) 837-8583.


Nearby Laboratory Resources


Access the Patient Portal: