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UWA Medical History and Immunization Form

Please complete the medical history form and supporting documents available through the link below.

All students must submit completed forms and supporting documentation when applying.

Please review the information at the following website for complete information regarding immunizations: https://www.uwa.edu/admissions/undergraduate/studenthealthservices

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Where would you like to study?

What is your current status?

Program of Interest

Guardian's First Name

Guardian's Last Name

Guardian's Email

Guardian's Phone

First Name

Last Name

Phone

Country

State

Street Address

City

Zip

Anticipated Major

High School Graduation Year

Anticipated Start Term

Anticipated Start Year

Student's Anticipated Major

Student's High School Graduation Year

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UWA Medical History and Immunization Form

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