Get the free Bformb - Campus Health - health iupui

IU Employee Name: Last, First, MI (please print) Campus Address (Campus×Bldg×Room#) HEALTH SCREENING VERIFICATION FORM Date Employee ID #: Employee Work E-mail Phone: Indiana University (IU) is

How to fill out bformb - campus health

How to fill out bformb - campus health:

1. Start by entering your personal information, such as your name, date of birth, and contact information.
2. Provide your insurance details, including the name of your insurance company and your policy number.
3. Indicate any known allergies or medical conditions that may be relevant to your campus health record.
4. Specify your emergency contact information, including the name, relationship, and phone number of the person to be contacted in case of emergency.
5. Next, fill out the medical history section, providing details about any past illnesses, surgeries, or medications you are currently taking.
6. If applicable, disclose any mental health history or concerns that you want campus health to be aware of.
7. Specify the name and contact information of your primary care physician or any other healthcare provider you have been seeing.
8. Lastly, sign and date the form to confirm the accuracy of the information provided.

Who needs bformb - campus health:

1. Students requiring access to campus health services should fill out the bformb - campus health form.
2. This form is essential for individuals seeking medical attention at the campus health center.
3. Whether you are a new student or a returning student, it is important to complete this form to ensure that campus health is aware of your medical history and can provide appropriate care.

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What is bformb - campus health?

The bformb - campus health is a form used to report health information for students on campus.

Who is required to file bformb - campus health?

All students and staff who are on campus are required to file bformb - campus health.

How to fill out bformb - campus health?

To fill out bformb - campus health, students and staff must provide their personal health information and any symptoms they may be experiencing.

What is the purpose of bformb - campus health?

The purpose of bformb - campus health is to monitor the health of students and staff on campus in order to prevent the spread of illness.

What information must be reported on bformb - campus health?

Information such as current health status, symptoms, recent travel history, and any contact with sick individuals must be reported on bformb - campus health.