Before Arrival Checklist
All forms are available at www.missouriwestern.edu/healthserv/
_____ Read Immunization/Screening Requirements.
_____ Complete Immunization Documentation Form, signed by healthcare provider, or provide Health Department, Physician, or School record for students living on campus.
_____ Complete and sign Health History Form.
Return all forms (Health History Form, Immunization Documentation Form, and waiver (if applicable) to:
Esry Student Health Center
Missouri Western State University
4525 Downs Drive – Blum 203
St. Joseph, MO 64507-9987
Phone: (816) 271-4495
Fax: (816) 271-4498
PLEASE TURN IN BEFORE the following dates:
Fall Semester – August 1
Spring Semester – December 1
Summer Semester – April 1
Please return directly to Esry Student Health Center, DO NOT submit with other Admissions materials.
If you have a significant health problem, please contact Esry Student Health Center before coming to campus.