Health History Form

Congratulations on your acceptance to Lake Forest College!  The Health & Wellness Center provides a range of health and wellness services to all Lake Forest College students with the aim of supporting students in achieving academic and personal excellence. We look forward to welcoming you to campus and serving your health and wellness needs.

Prior to your enrollment we need information about your health status and signed documentation of your immunization history. It is important that you complete the Medical History Form with immunizations located in the Lake Forest Student Health Portal lakeforest.studenthealthportal.com/ by July 15, 2021.

 Students not in compliance with immunization requirements during their first term of attendance are restricted from registering for subsequent terms until compliance is obtained, per mandate of the State of Illinois, and may be subject to a late fee of $100. 

 You will need your Lake Forest College-issued username and password to log in to the Health & Wellness Student Health Portal and complete the medical history form and upload your immunizations. You should have received your Lake Forest College log-in information from the College in an email in mid-May.

 Before completing all necessary forms please make certain you have the following items:

Immunization Record (Based on State of Illinois Law and College Policy)

  • Signature of licensed Health Care Provider or certification from a health agency or clinic is required at the end of the Immunization
  • Enter immunization dates under the ‘Immunization’ tab in the Lake Forest Student Health Portal, as well as upload supporting documentation with signature by your health care provider.

Tuberculosis Screening Questionnaire

  • All students must complete the tuberculosis screening questionnaire prior to arrival on campus.
  • If appropriate, TB testing must be completed no earlier than 6 months prior to arrival on campus and prior to registration for the second semester.

Medical Consent for Minors

  • If you will be under the age of 18 when entering as a student at Lake Forest College, a parent or legal guardian must sign consent to permit treatment at the Health and Wellness Center.

Medical or Religious Exemptions to Immunizations

  • Exemption from immunization may result in quarantine of non-immunized students off grounds in the event of a contagious disease
  • Complete the Immunization Religious Exemption form to apply for a religious exemption
  • Provide documentation from your licensed Health Care Provider for medical exceptions.

Health Insurance Information

  • Health insurance is mandatory. If you are not covered by your parent/guardian’s policy, you must either enroll in the Student Health Insurance Plan (Cigna PPO) offered by the College through the Gallagher Insurance Agency (com), or purchase a health insurance policy from the Insurance Marketplace at HealthCare.gov, or through an independent insurance broker.
  • Please Note: Your health insurance must cover medical, mental health, and emergency services. If you are an out-of-state student, please verify that your insurance plan provides coverage in Illinois. Many plans have limitations that you should be aware of before arriving on campus.
  • Medicaid plans only provide coverage in the state in which the student is a resident.

The Health and Wellness patient portal can also be accessed on our Health Services web page. If you are not able to upload your immunizations into the Student Health Portal, please contact the Health and Wellness Center at healthandwellness@lakeforest.edu.

Questions?

Mary E. Grigar, Ph.D.
Assistant Dean of Students
Director of Health and Wellness
healthandwellness@lakeforest.edu

Phone: 847-735-5240
Fax: 847-735-6098