Contact Information
110 Student Health and Wellness Center
(919) 760-8535
healthcenter@meredith.edu
Welcome to 糖心Vlog from the Student Health and Wellness team! Listed below are the specific forms that you will need to complete in the . Please note that some of the forms will need to be printed and completed by your primary care provider.
All forms can be accessed through the student wellness portal, on the front page of the portal under 鈥淧ending Forms鈥�, using your Meredith email and password. You will gain access to the portal using your Meredith account information prior to your on-campus StartStrong session.
You are encouraged to start working on the paper forms (downloadable from this page) now even before you have your 糖心Vlog credentials to access the portal.
Fall entry deadline for all forms is July 1.
Spring entry deadline for all forms is December 1.
Summer entry deadline for all forms in May 1.
Not sure how to use the new portal? Watch our to the Student Wellness Portal.
Required Forms
The forms listed below must be completed by all students. This includes all applicable forms in the Portal Forms section and all applicable forms in the Paper Forms section. Student athletes may have some additional forms that need to be completed.
Portal Forms聽
These forms should be completed in your and can be found under 鈥淧ending Forms.鈥� Any forms that must be printed from this section should be submitted via the portal once completed.
- Authorization and Consent to Treat
- Self Report of Medical History
- Self Report of Family History
- Communication Preferences
- Emergency Contacts
- Tuberculosis (TB) Screening
Paper Forms聽
Complete these forms and submit them through the聽with the appropriate/corresponding portal form.
- Immunization Record*
- Underage Consent to Treat*
- TB Risk Assessment (if needed)*
*Immunization Record (PDF, download here) 鈥� The State of North Carolina requires that all immunization records be completed and signed by a healthcare provider (MD, DO, NP, PA) in order to be accepted as valid records. Please download and complete this form with your provider. When completed and signed, log in to the student wellness portal, add the dates of your immunizations in the online immunization portal form and then upload a scanned copy of your signed record under the State-Required Immunization form. You will not be able to submit your immunization record through the portal without uploading the signed record. To learn more about Meredith鈥檚 immunization requirements, please visit the Vaccine and Exemptions page on our website.
- Domestic/International Health Department Immunization Record
- High School Transcript or College/University Record
- Military Record
- NC Immunization Registry (NCIR) or Other State Immunization Registry Record
- 糖心Vlog Immunization Record Form
NOTE: All forms of immunization documentation must be signed by a healthcare provider or stamped by a health department.
*Underage Consent to Treat (PDF, download here) 鈥� If a student is under the age of 18 years old this form must be completed and signed by a guardian. Please complete and submit the completed form through the portal consent form.聽
*TB Risk Assessment (PDF, download here) 鈥� This form should only be completed if your portal TB Screening indicates you need a risk assessment. You will need to print it off and take it to your healthcare provider. Completed forms should be submitted via the 鈥淒ocument Upload” section of the student wellness portal like all forms within the “Paper Forms” section.
Optional Paper Forms聽
Exemption forms must be received in the Student Wellness Portal by July 1. Forms submitted after noon on the deadline day will not be reviewed.
- Medical Exemptions*
- Vaccine Religious Exemption*
*Medical exemptions can only be requested by a physician licensed to practice medicine in North Carolina. Medical exemptions for required immunizations will only be granted upon submission of either a Medical Exemption Statement (DHHS 3987) or Physicians Request for Medical Exemption (DHHS 3995).聽 Both of these exemptions require a signature by a Physician in North Carolina. These forms can be found on the .
*Vaccine Religious Exemption (PDF, download here) 鈥� If you require a religious exemption, download this form, complete it, and submit it through the聽聽under the 鈥淒ocument Upload鈥� tab and then select 鈥淚mmunizations鈥�.聽
Student Athlete Forms
All student athletes should complete the forms below in addition to all applicable forms on this page, including all applicable forms in the Portal Forms and Paper Forms sections.聽Please contact your athletic trainer if you have questions regarding these forms or submitting information.
- Sickle Cell Education Acknowledgement *
- Release of Information Form*
- Parent Insurance Information Form*
*Sickle Cell Education Acknowledgement (portal form) 鈥� Per the January Division III NCAA announcement starting in August 2022, all student-athletes are required to review sickle cell education and sign an attestation. Please upload your sickle cell results to the 鈥淒ocument Upload” section of the聽.
*Release of Information Form (portal form) 鈥� Consent to share the following forms with both the Student Health Center and Athletic Training: Personal Health History, Family Health History, Communication Preferences, Emergency Contact Information, and Immunization History.
*Parent Insurance Information Form (paper form)聽鈥� Athletics needs this information on file for every student-athlete prior to participation as a request from our secondary insurance provider, 1st Agency. If you are self-insured, please fill out the form based on your personal policy information.聽Please upload this form to聽the Insurance Policy Form under “My Forms” in the聽.
Health and Well-Being Resources
Mental Health Resources
If you would like to communicate with the Counseling Center about mental health resources on campus please email counselingcenter@meredith.edu or send them a secure message in the student wellness portal.
Allergy Injections
If you currently receive allergy injections and would like to continue to receive them at the Student Health Center, please email healthcenter@meredith.edu or send us a secure message in the student wellness portal if you are interested in this service.聽
Disability Services
The college welcomes requests for accommodations related to disability and will grant those that are determined to be reasonable. To make such a request, or begin a conversation, please call email disabilityservices@meredith.edu or send them a secure message in the student wellness portal. Accommodation documentation can be submitted directly through the 糖心Vlog Wellness Portal.聽
COVID-19 Guidance
Review this form for updated Centers for Disease Control and Prevention (CDC) COVID-19 isolation guidance.
Information About Preventable Diseases
North Carolina law requires that we provide all new incoming students and parents with information about the following:
- 听听
Frequently Asked Questions
Yes, these forms will provide the basis for your medical chart which will be utilized when you visit the Student Health Center. You must complete these forms in addition to any forms that may be required separately by 糖心Vlog Athletic Department. Some forms can be shared between departments after a release of information is completed.
NC Immunization Law (General Statute 130A 155.1) states that freshmen entering college for the first time must present physician-signed/clinic stamped evidence of the immunizations noted as required on the health form. The law requires that students be pulled from classes if they have not presented an immunization record. Please note that the student is not permitted to pick and choose what state required immunizations they want to receive. To learn more about Meredith鈥檚 immunization requirements, please visit the Vaccine and Exemptions page on our website.
North Carolina law provides for only two types of exemptions from required immunizations:
- Medical exemptions can only be requested by a physician licensed to practice medicine in North Carolina. Medical exemptions for required immunizations will only be granted upon submission of either a Medical Exemption Statement (DHHS 3987) or Physicians Request for Medical Exemption (DHHS 3995).聽 Both of these exemptions require a signature by a Physician in North Carolina. These forms can be found on the .
- Individuals whose religious beliefs prevent them from obtaining any immunizations should complete a religious exemption form. Please download this form, complete it, and submit it through the portal. According to North Carolina general statute 130A-157, 鈥渦pon submission of a written statement of the bona fide religious beliefs and opposition to immunizations the person may attend college without presenting a certificate of immunization鈥�. This form must be written and signed by the student if age eighteen or older or the parent if the student is under the age of eighteen.
You should start the series, have your provider note the dates on your immunization record and send your immunization record to us. We will assist you in completing the series after your arrival here or let you know if it is acceptable for you to complete the series at home over the academic breaks. The series must be completed within an acceptable timeframe or North Carolina law requires that you be removed from classes.
The NCAA-required sickle cell test report should be uploaded in the documents on the student wellness portal. Per NCAA requirements, you will also need to sign and acknowledge the provided sickle cell education form on the student wellness portal.聽
For any questions about student health insurance, please go to the Student Health Insurance page or contact us if your question is not answered there.
