Campus Clinic Health Forms

Complete Student Health Forms and Immunization Records are required prior to beginning class at Wilmington College. Please submit forms for the spring 2015 semester via fax to 937-383-8564 or via the mail to: Student Health Center, Pyle Center Box 1231, 1870 Quaker Way, Wilmington, Ohio 45177.

Please pay special attention to proper immunization records and immunization requirements.

Please complete the following:

Complete this Electronic Form

  1. Once it is filled out completely, save it to your computer witht he following file name:
    • Last Name, First Name, Student ID.doc (Example: Smith, Vivian 661217.doc)
  2. After you have save the document you can:
    • Print and mail to Student Health Center, Pyle Box 1231 (preferred method)
    • Email the form to
    • Fax it to Admissions at 937-382-8542

Required Immunizations

For questions, call:

Wilmington College main number: (937) 382-6661
Director of Health Services
Jill Young, ext. 217