Please read the following options carefully, and select the appropriate forms to download.


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Medical Health Forms for Incoming Class of 2024 and Transfer Students

As a condition of enrollment at Lafayette, the Bailey Health Center must ensure that students meet certain health requirements.  It is critical that you allow sufficient time to see your healthcare provider

All Bailey Health Center forms must be completed, records in any other format will result in a surcharge of $50 to the student account.

All forms must be completed by August 1, 2020.

Essential Medical Forms for Class of 2024 and Transfer Students

Upperclassman Required Forms

Insurance Information for 2020-2021
Complete Insurance forms and upload to patient portal.

Instructions to complete Insurance Requirement

Complete the following forms online: Emergency Notification Form

Air Conditioning Request

Air conditioning is limited in some residence halls and students are not permitted to have air conditioners installed in their room except for rare cases of documented medical condition or disability. If your residence hall does not have a central air conditioning system and you require it for a medical condition or disability please have your medical provider complete the form below and return it to the Bailey Health Center.

Air Conditioning Request Form

Insurance (Required)

Provided Insurance information electronically on the Patient Portal.