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Important Documents

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Health Insurance information

file-outline Ithaca College MVP Health Care insurance brochure - ICMVPSOB0 2420.pdf (1.34 MB)

Summary of Benefits: Ithaca College MVP Health Care plan for 2020-2021 school year.

Common Health Concerns

file-outline Chlamydia Information - Chlamydia.pdf (108.33 KB)

Learn about Chlamydia 

file-outline BRAT diet - BratDiet.pdf (55.48 KB)

Nausea? Vomiting? Try these foods first to ease your body back into solid foods.

file-outline Influenza FAQ's - Influenza.pdf (48.88 KB)

FAQ's about the flu

file-outline Mononucleosis - Mononucleosis.pdf (262.33 KB)

Learn about Mononucleosis. Symptoms, self care.

file-outline Strep throat - StrepThroat.pdf (40.99 KB)

Learn about strep. Symptoms, self care, precautions.

file-outline Urinary Tract Infections - UTI.pdf (63.37 KB)

Lear about UTI's - symptoms, self care.

Health Certification Forms for NEW STUDENTS

file-outline Immunization Form - required - Immunizationform.pdf (114.77 KB)

Immunization health form for Health Certification requirements

file-outline Meningitis Disease Law information - Meningitisletter.pdf (127.71 KB)

Meningitis Disease Law information. Read details about requirements for meningitis vaccination in the college setting.

file-outline Tuberculosis assessment form - required - TBAssess.pdf (258.19 KB)

Tuberculosis assessment form. 

file-outline Required Forms for Minors - Required Forms for Minors (revised July 2016).pdf (133.67 KB)

Contains three forms. Consent for Treatment of a Minor, Notice of Privacy Practices Receipt, Meningococcal Meningitis Vaccination response form.

file-outline Immunization consent form for MINORS - ImmunConsent_0.pdf (45.49 KB)

If the student is under 18, this form must be filled out by a parent or guardian. Without this form the Health Center is unable to administer the immunization to a minor. 

file-outline Physical Form - PhysicalForm.pdf (372.96 KB)

IC Physical form

file-outline Wegmans Pharmacy Form - Wegmansform.pdf (475.34 KB)

Insurance information form and authorization to release medication (authorize delivery of medication from Wegmans to Ithaca College)

Business Office Forms

file-outline Handicap Parking Permit DMV form - DMV6641.pdf (122.74 KB)

Handicap Parking Permit DMV form

file-outline Athletic Injury Form NCAA - AthleticInjuryClaim.pdf (53.43 KB)

Participating in NCAA sport and are injured? Athletic Injury Form NCAA

file-outline Student Health Insurance Information - Insurance_Flyer.pdf (596.66 KB)

Student Health Insurance Information

file-outline Release of Information Form - ReleaseInfo.pdf (71.24 KB)

Release of Information Form for Medical Records

file-outline Complaint Form - PatientComplaints.pdf (376.75 KB)

Have a comment or complaint? Please use this form.

file-outline Health Center Informed Consent for Telehealth - Health Center Informed Consent for Telehealth_4-24-2020.pdf (383.9 KB)
file-outline Notice of privacy practices - Notice of privacy practices HC.pdf (33.88 KB)