Forms

Immunization Information and Form

State required immunization information and immunization form.

Release of Information

A valid authorization signed by the patient is required to release any health information. Diagnosis of mental health, alcohol and substance abuse and AIDS/HIV are NOT included in a general authorization and must be indicated specifically on the release of information form. Please allow 24 - 48 hours process time for all releases. There is a cost to obtain personal copies. Please contact Health Services for more information 815-753-1318.

Release of Information form (pdf).

Student Insurance Forms

Forms related to Student Insurance are available on the Student Health Insurance Web site.

Medical Withdrawal

Withdrawal from all university classes for a specified semester.

• Medical Withdrawal Form (pdf)

Course Load Reduction

Reducing classes during a specified semester.