Student Health Services Forms



Please be sure to review the Student Health Insurance Plan and, if you have comparable private insurance, to waive out at www.gallagherstudent.com/conncoll. You must also submit a copy of your private insurance card, front and back, to Student Health Services.

Send to:
Student Health Services
Box HLTH CTR
Connecticut College
270 Mohegan Avenue
New London, CT 06320-4196

Forms for mid-year students:

  • Connecticut College Health History Form (filled out via the Student Health Services' Web Portal, http://connc.studenthealthportal.com/).
    The due date for completion of this form is January 12, 2015.

  • Student Health Services Medical Clearance and Proof of Immunizations Form
    Please print and take this form to your physician for completion. Once complete, you may scan and upload the form via our Student Health Services' Web Portal, http://connc.studenthealthportal.com/, under "Document Upload", or scan and email it to SHS@conncoll.edu, or fax it to us at (860) 439-5430. The due date for completion of this form is January 12, 2015. If your physical is not scheduled until after January 12, 2015, please be sure to complete and submit the form before your arrival on campus. 

Forms for current/returning students:

Contact Information


Phone: 860-439-2275
Fax: 860-439-5430


Email: shs@conncoll.edu


Student Health Services
Warnshuis Building
Connecticut College
270 Mohegan Avenue
New London, CT 06320-4196