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Health Forms

As a new Wisconsin Lutheran College student, you are required to provide your health history, immunization record, and personal health insurance information. You must also provide the results of a recent physical exam if you are or plan to be a student-athlete, or if you have a chronic medical condition.

  • STUDENT-ATHLETES

    If you will be or plan to be a student-athlete at WLC, you ONLY need to access the HIPAA-compliant online Athletic Trainer System (ATS) Portal to submit your health history and other required information. The Student Health Center will import your information from the ATS Portal for their files.

    Please let the Warriors Athletic Training staff know if you have any questions or concerns. You can reach the staff via email at wlcsportsmed@wlc.edu.

    Here are the steps you need to take:

    1. INSTRUCTIONS: Read the ATS Portal instructions for setting up your username and password and completing the required forms.

    2. ACCESS THE ATS PORTAL: Log in to the ATS Portal and complete all of the required information by July 15.

    3. PHYSICAL EXAM: All freshman and transfer athletes need to have a sports medicine physical completed and uploaded to ATS. This physical form can be downloaded from the ATS portal in the eFiles tab. Print it out and take it along to your physical exam. Once it is filled out by the doctor, you can upload it back into ATS.

    4. PERSONAL HEALTH INSURANCE CARDS: You will have to upload a photo or a scan of the front and back of your insurance card. Please bring copies of the front and back of your insurance card with you to campus as well. Take the copies of your card with you to your athlete screening session in case there are questions.

    5. ASTHMA: For athletes with documented asthma, bring us a duplicate of your inhaler with a script from your doctor.

    ATS PORTAL INSTRUCTIONS

    ATS PORTAL LOG-IN

    WARRIORS SPORTS MEDICINE SITE

    ALL OTHER STUDENTS

    For new undergraduate students who do not plan to compete in Warriors Athletics, ALL THREE online, HIPAA-compliant forms listed below must be completed by August 1. The information you submit will be kept on file in the Student Health Center. Failure to supply the required information can result in restrictions from campus activities or residency.

    Please let the Student Health Center know if you have questions or concerns. You can reach the staff via email at healthservices@wlc.edu.



    1. HEALTH HISTORY FORM:
    This information will be used if you seek services at the Student Health Center and in emergencies. The health history you submit informs our medical staff so they can develop a baseline of care for you. If you indicate on your form that you have a chronic condition, you must provide the Student Health Center with a copy of a recent physical exam (within the past 12 months) when you arrive on campus. 

    HEALTH HISTORY FORM



    2. IMMUNIZATION RECORD FORM: You must provide WLC with your immunization record. Required immunizations include Measles, Mumps, and Rubella; Diphtheria, Tetanus, and Pertussis in some form, with Tetanus no more than 10 years old; and Varicella vaccination or date of Chicken Pox disease. A negative TB skin test is required if you have lived abroad prior to arriving on campus. You will have the option of uploading your immunization record or typing in the dates of your immunizations. If you have not been immunized or do not have your record, please see the Immunization Record Form for more information.

    IMMUNIZATION RECORD FORM



    3. PERSONAL HEALTH INSURANCE FORM:
     You must provide the Student Health Center with contact information for your health insurance company. You must also upload a photo or scan of the front and back of your insurance card. This information will be used in case of an emergency or when services are being ordered that are outside the scope of practice on campus.

    PERSONAL HEALTH INSURANCE FORM