State required immunization information and immunization form.
Prior to your first visit to the Health Services, you will be instructed to print off and bring the completed Health Services Health History form (pdf) to your scheduled appointment.
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).
Forms related to Student Insurance are available on the Student Helath Insurance Web site.
You may be instructed to print off and bring the completed Health Services Women's Health History form (pdf)
to your first women's health visit and annually thereafter.
Medical Withdrawal - Withdrawal from all university classes for a specified semester.
Course Load Reduction - Reducing classes during a specified semester.
Housing & Dining Change Request for Medical Reasons – Students requiring special needs changes concerning dietary issues, room accommodations, etc., for a specified semester.
Student forms below: