Health Forms & Policies





All required health forms are to be submitted through the following link:


Use your Goucher College ID and password to log-in.

In order to provide the best possible medical care, we require each incoming student to complete the required forms which include Medical History (online survey) and Physical Examination and the Immunization Record on or before July 13th (for Fall 2020). These forms are available at

The physical examination is to be completed by a physician, nurse practitioner, or physician’s assistant of your choice, and must have been completed within the 12 months prior to your enrollment date. Please use the form provided by Goucher College.

Goucher’s immunization requirements follow guidelines set by the American College Health Association and the Centers for Disease Control and Prevention. Immunization requirements may vary from state to state; we therefore recommend that your health care provider review our form carefully, assess your status, and update your immunizations as needed to fulfill our requirements. Please see Goucher’s immunization policy.

*PLEASE NOTE, STUDENTS WHO HAVE NOT TURNED IN VACCINATION RECORDS FOR THE FOLLOWING MANDATORY VACCINES: MMR, TETANUS, & MENINGITIS (waivable) WILL NOT BE PERMITTED TO MOVE ONTO CAMPUS. If you are seeking a vaccine exemption for MMR or Tetanus, you must contact the Director of Student Health @ to discuss your exemption and receive the proper form. Personal belief exemptions are not accepted.  Relgious and medical exemption forms must be accompanied by a letter from a Physician/NP/PA or clergy member. 

State law requires that any individual enrolled in a Maryland institution of higher education who resides in on-campus housing must be vaccinated against meningococcal disease, or sign a waiver, which can be completed at

Along with the medical history, physical, and immunization information, it is a requirement that all incoming students have health insurance and provide a copy of their health insurance information.

Students who fail to return their forms, or who are not in compliance with our immunization requirements, will be assessed a non-compliance fee of $100 on 9/14/2020. These student will also not be permitted to register for the following semester until requirements are met.

Required Health Forms

(also available at

Insurance Form

Additional TB testing (If screened med-high risk)

Immunization Record

Physical Exam form

Miscellaneous Health Center Forms (not required)

Authorization for Release of Confidential Records and Information (PDF)

Vaccination Parental Consent Form (PDF) (For students under 18 years old)

Additional Policies

Chaperone and Sexual Abuse Prevention Policy (PDF)