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Get the free ECSU Student Medical History Form for Global Field Course Program - easternct

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This form collects medical history information from students participating in the Global Field Course Program, ensuring their health and safety while abroad.
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How to fill out ecsu student medical history

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How to fill out ECSU Student Medical History Form for Global Field Course Program

01
Obtain the ECSU Student Medical History Form from the program's website or the designated office.
02
Read the instructions carefully to understand the required information.
03
Fill in your personal details, including your name, date of birth, and contact information.
04
Provide information regarding your medical history, including any allergies, chronic illnesses, or previous surgeries.
05
List all current medications you are taking, including dosage and frequency.
06
Complete any sections regarding immunizations, providing dates for any vaccinations you have received.
07
Include emergency contact information, including the name and phone number of someone to reach in case of an emergency.
08
Review the completed form for accuracy and completeness.
09
Sign and date the form as required to certify that the information is true and complete.
10
Submit the form by the specified deadline to the appropriate office or program coordinator.

Who needs ECSU Student Medical History Form for Global Field Course Program?

01
All students participating in the Global Field Course Program at ECSU are required to complete the Student Medical History Form.
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The institution's first name was Elizabeth City State Colored Normal School (1891-1939).
Elizabeth City, North Carolina was incorporated in 1793 as the town of "Redding" by the North Carolina General Assembly. The City's name changed to "Elizabeth Town" in 1794, and subsequently became "Elizabeth City" in 1801, also by acts of the General Assembly.
Elizabeth City State University was established by the North Carolina General Assembly on March 3, 1891, as the State Colored Normal School at Elizabeth City, in response to a bill calling for the creation of a two-year Normal School for the "teaching and training [of] teachers of the colored race to teach in the
Notable alumni NameClass yearNotability Mike Gale 1970 Former professional basketball player in both the ABA and the NBA Johnnie Walton 1975 Former NFL quarterback with the Philadelphia Eagles and the Boston Breakers of the USFL. Everett McIver 1993 Former NFL offensive guard Bobby Futrell 1985 Former NFL defensive back8 more rows
Quick Facts Undergrad Population: 3240 Graduate Population: 67 Student Body: Coed In State Tuition: $3829 Out of State Tuition: $13572 Room & Board: $6283 Applications Due: Rolling Admissions ($30) Conference: Mascot: Vikings Accreditations: Online Classes: yes Percent Men: 44% Percent Women: 56%1 more row

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The ECSU Student Medical History Form for the Global Field Course Program is a document that collects important health information from students participating in global field courses to ensure their safety and well-being during travel.
All students who wish to participate in the ECSU Global Field Course Program are required to file the ECSU Student Medical History Form.
To fill out the ECSU Student Medical History Form, students should carefully read the instructions, provide accurate personal and medical history information, and ensure all required sections are complete before submission.
The purpose of the ECSU Student Medical History Form is to gather necessary medical information to facilitate appropriate health care and emergency support for students during their global field experiences.
Students must report their personal health history, current medications, allergies, any chronic conditions, and emergency contact information on the ECSU Student Medical History Form.
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