A Medical History Report form will need to be submitted for every student attending Doane College. This form can be found in the Student Health packet. The Student Health packet is crucial for the nurse to be able to provide individual services to each student. Medical personnel cannot make a valid diagnosis without proper knowledge of a student's medical history.
If you need your medical records released to another institution or facility, please fill out and return the Authorization for Release of Medical Information form.
In order to download these PDF forms, you will need to have Adobe Acrobat Reader installed on your computer.
If you have additional questions or concerns about the Medical History Report form or the Student Health packet, please contact our Director of Health and Wellness,
Kelly Jirovec:
work: 402.826.8265
home: 402.826.3541
e-mail: kelly.jirovec@doane.edu