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To All Entering Students,

Allow me, Dr. Hernandez, to welcome you to the Westmont College Student Health Center. During your time at Westmont you will have access to an on-campus health clinic at which a team consisting of a physician assistant, registered nurse, medical office coordinator and physician will be available to take care of your health care needs. Please visit the health center page to learn more about the health center staff and the services available.

In an effort to better serve you, it is important that you complete the forms listed below. You will need to print and fill out each form attached and mail them to "Westmont College Health Center." The address if listed at the bottom of the page.

Health Forms:

Immunization Form
A list of all the immunizations (shots) you have received. You. your doctor or your parents will have this record. Please mail the completed immunization form back to the Westmont College Health Center. It would be a good idea to make a copy of this form for your own records.

Consent Form
All students entering Westmont College who are under 18 years of age must have a consent form signed by a parent/guardian to receive treatment in the Health Center.

Physical Exam
All students entering Westmont College are highly recommended to have a physical exam before coming to campus.
Health History Form
To insure the best care possible, all students entering Westmont are required to have a health history form filled out before being seen/treated in the Health Center.
A copy of the front and back of your insurance card is needed in the event you need to be treated off campus. You do not need insurance to use the Health Center on campus. Insurance is only needed if being referred off campus. If you have an HMO, please consider having a Santa Barbara Primary Care Physician assigned to you in the event you do need a referral off campus.

TB Questionnaire
The requirements for TB testing has changed. Please review and complete this questionnaire. If necessary, print the TB Risk Assessment form and bring to your physical exam for you doctor to complete.

Print these forms, take them with you for your physician to complete and mail back to thefollowing address no later than August 1st :

Westmont College Health Center
955 La Paz Road
Santa Barbara, CA 93108

*If you have any concerns regarding returning the forms back by August 1st, contact Claire Cetti at ccetti@westmont.edu or call us at 805-565-6164.