Policies and Forms

Medical History and Immunization Records

Any student born after 1956 is required to provide documentation of receiving 2 measles, mumps, and rubella shots (2 MMR's), OR provide documentation of blood (lab) results for measles, mumps and rubella.

Signatures of medical providers or photocopies of medical records are required.

The TB questions on the health form MUST be answered. If you answer NO, nothing further is needed.

The meningitis vaccine is highly suggested for new students living in the dorm setting. The state of Iowa requires a signature of waiver if you decline the vaccine.

Students who have not satisfied the above requirements will not be permitted to register for the following semester’s classes.

• Medical History Form (pdf)

Please send completed health form/immunization documents directly to the Student Health Center by the second week after classes start. Please provide a copy of your insurance card.
Send all records at the same time:
BY MAIL:
Drake University Student Health Center
3116 Carpenter Ave., Des Moines, IA 50311
BY FAX:
515-271-1855
BY EMAIL:
studenthealthcenter@drake.edu

International Student Health Insurance

International students will automatically be enrolled into the Drake-offered Student Health Insurance Plan.

The monthly premium rate is $104.00 which will be charged the student’s account.
The plan also allows international students to enroll a spouse and / or dependent(s). 

For more information, contact the Drake International Department at 515-271-2084 or visit www.lewermarkinsurance /drake.

Release of Medical Information

For cases where the American Republic Student Health Center (ARSHC) needs medical records, or if another medical facility should request medical records from the ARSHC, the student will need to complete the “Authorization for Release of Medical Information” form.

This form specifies who’s releasing the information and where the student would like the information to be sent.

All substance abuse, mental health and HIV-related information need to be specifically authorized for release of information.

Voluntary Medical Leave of Absence

The “Voluntary Medical Leave of Absence” form is to be completed by students requesting a temporary leave from Drake University.

Upon completing the form, it may be provided to any one of the following:

• Associate Dean
• Drake University Counseling Center
• Drake University American Republic Student Health Center 

Student Health Insurance

Parents or students in need of health insurance should explore other options by visiting www.healthcare.gov. Parents can also elect to keep their child on their current plan if they prefer.

It’s also recommended students have their insurance card on them and understand what their coverage entails.