All incoming students are required to provide emergency contact information, health insurance information, their medical history, and their immunization history. Please complete your medical forms online by July 14, 2017.
All medical forms can be completed online through your My.Carthage portal in the Medical Information section.
See My.Carthage login instructions.
Health Insurance Information
If you need treatment off campus while you are a Carthage student, your health insurance information will be released to the healthcare provider upon request. This information is also needed to submit claims to the College supplemental accident and sickness benefits.
- We strongly advise students to bring their health insurance card to campus.
- If you are from out of state, please call your health insurance company and alert them that you will be out of state during the academic year. Many plans require the policy holder to sign up for “away from home” care.
Medical History Questionnaire
Accurate health information is essential to provide you with the best care possible. Students often forget past medical history, medication allergies, and routine medications when ill. This information is confidential and will not be released to anyone outside Carthage College without your permission, except as required by law, such as with court-ordered release, or in reporting of certain communicable diseases to the Department of Health.
Online Meningococcal Meningitis/Hepatitis B Response
State law requires that all colleges and universities in Wisconsin annually inform students about the risks associated with meningococcal meningitis and hepatitis B, and the availability and effectiveness of vaccines against these diseases. State law also requires that students who live in residence halls affirm that they have received the required information. All incoming Carthage students were mailed this information in June. You will need to affirm that you received and read the information. Note: This form will not appear until students have turned 18 years old, so if you’re turning 18 this summer, you’ll need to complete the response form on or after your birthday.
Immunization History Form
All students must submit their immunization history to Carthage. You can print the form at www.carthage.edu/medical-forms. Note: You must have your healthcare provider sign and stamp the form, or provide a copy of your vaccination record. Carthage requires a tetanus booster within the last 10 years, and two doses of Measles, Mumps, and Rubella (MMR). International students may also need tuberculosis testing. (Please contact the Health and Counseling Center regarding tuberculosis testing if you are an international student.) You can obtain your vaccination records from your healthcare professional or former high school. If you were vaccinated in Wisconsin, your vaccination history may be available on the Wisconsin Immunization Registry. Immunization dates must include month, day, and year.
Please make every effort to have your records sent to the College prior to enrollment in classes. It becomes increasingly difficult to track down records after you arrive on campus. If you are unable to obtain your vaccination record, you may need to be re-vaccinated or have an immunity profile completed. Please contact the Health and Counseling Center at 262-551-5710 as soon as possible to discuss your individual circumstance.
Parent/Legal Guardian Consent Form
You only need this form if you will be 17 or younger on the first day you arrive on campus. You can print the form at www.carthage.edu/medical-forms.
Contact the Health and Counseling Center at 262-551-5710 or firstname.lastname@example.org.