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 new 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 July 15, 2014. 

  • Medical Clearance and Proof of Immunizations Form
    Please print and take this form to your physician for completion. Once complete, you may upload the form via our Student Health Services' Web Portal, http://connc.studenthealthportal.com/, or scan and email to SHS@conncoll.edu, or fax it to us at (860) 439-5430. The due date for completion of this form is July 15, 2014. If your physical is not scheduled until after July 15, 2014, please be sure to complete and submit the form before your arrival on campus on August 22, 2014. 

Forms for current/returning students:

Download Adobe Acrobat Reader

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