Mandatory Health History Questionnaire
The Mandatory Health History Questionnaire must be completed by each incoming full-time student (resident and commuter) and returned to Student Health Services. This form provides our health care providers with health information including immunizations and a baseline physical exam which will allow for the most optimal level of care. This form can be obtained at Student Health Services or by accessing the link below.
Please see the required Mandatory Health Form.
On April 1, 2019 Student Health Services will be transitioning to an electronic Student Health Portal and will no longer be using the hard copy Mandatory Health Form. If you have already submitted the Mandatory Health Form we will upload it electronically for you and no other forms will need completed at this time. If you have not yet completed the hard copy Mandatory Health Form, you can wait to complete the required health forms online on or after April 1 by logging in to your Student Health Portal. You will not be able to access the portal until you have received your Topper ID and westliberty.edu email address. Returning students do not need to complete new health forms every year. Athletes may have additional forms (please check with your Athletic Trainer.)
Instructions to log in to the electronic Student Health Portal can be found here:
Step 1 Log into the West Liberty University Student Health Portal (westliberty.studenthealthportal.com)
- Register for the Student Health Portal.
You will need your Topper ID (include the @) and your westliberty.edu email address to register.
- Once you register, check your email for a link to create a password.
- Once you create a password you will be prompted to log into the portal.
When you use this portal you are accessing your own confidential protected health information. To protect your privacy, do not share your portal login credentials.
- After logging in, please read the instructions on the portal and complete all pending forms.
Please use the Forms below after April 1, 2019:
Physical Exam Form
A physical is required for all full-time incoming students, all athletes, and any part time or graduate student wishing to use Student Health Services. Once this physical is completed by your health care provider, please UPLOAD IT to your Student Health Portal via the Document Upload function.
Download here: Physical Exam Form
Guardian Medical Consent Form
This form will need completed by your parent/guardian if you are under age 18.
Download here: Guardian Medical Consent
Immunization Waiver
This form will need completed by your health care provider if you have a valid reason to be exempt from immunization requirements.
Download here: Immunization Waiver
