Pre-Entrance Health Requirements

Welcome! A number of forms must be completed and returned to the Mount Holyoke College Health Center no later than July 1, 2013 for Fall Entrants. Forms for Spring Entrants are due to the Health Center no later than December 1, 2013. Please download the required Incoming Student Forms. You and your Health Care Provider must complete the forms. These forms cannot be completed online. Each file has one page of instructions and a form.

These forms can be printed as either single or double-sided copies. An envelope addressed to the Health Center has been included in this packet for your use in mailing the completed forms. When mailing the completed forms please do not include the instruction pages or staple any forms together. You may also email the forms to Health Services (health-services@mtholyoke.edu) or fax to 413-538-2352.

Students entering or transferring to all Mount Holyoke College programs must meet all pre-entrance requirements.

  • Contact Information
  • Consent to Treat (If Date of Birth is after 08/26/1995)
  • *Medical History
  • *Physical Exam
  • *Immunization Record
  • *Tuberculosis Screening Form
  • Meningitis Waiver (See Instructions)
  • Sickle Cell Trait Form (Varsity and Club Athletes)

*Require signature of health care provider

If you are unable to download and print the forms we will mail them to you. To request forms, please email Health Services and include your name and mailing address.

If you have questions about any of the requirements, you may email or call 413-538-2089.