Incoming Students Forms Due July 15

You will complete some of the health forms online; others you will download, fill out, and mail to us.

Before you mail your forms, make copies for yourself. Bring the copies with you when you come to campus in case you need them.

Note: If you leave online forms idle for more than 10 minutes, you will be logged out.

If you have Internet-based difficulty completing the forms, please try a different browser. If you have continued difficulties, please let us know.

To access the health forms, please log into My SHACS Info.


Online Forms

Consent for treatment form
Read the form carefully, complete, sign, and submit online.
Student health history form
Read this section carefully, complete, and submit online.

Online Forms with Mailed Parts

Immunization history form
Review the form to see what you will need. Log off to collect all of your immunization records. When you have them, log back in, complete all sections that apply, and submit online.
Mail a copy of your official immunization record to SHACS.
Tuberculosis screening form
Answer all five questions, and submit online.
If you answer yes to any of these, print the TB evaluation form. Take this form to your physician to complete.
Mail the completed form to SHACS.

Mailed Forms

Medical Provider Report of Health Evaluation
Required of all incoming first-year students and language assistants.
Download and print this form.
Take it to your provider for your health physical.
Mail this completed form to SHACS.
Consent for treatment of a minor
Required if you will be under the age of 18 when you arrive on campus. If you will be at least 18, you do not need to complete this form.
Download and print this consent. Have your parent or legal guardian sign the form.
Mail this completed consent to SHACS.
Insurance Card
Bring your insurance card with you when you come to campus; you will need it to use services off campus.
If you don’t have your own card, request a duplicate card from your insurance provider. Mail a front and back copy (actual size) of your insurance card.
If you are an athlete, submit physical forms to both the Athletic Department and to SHACS.
Mail your original health physical form to SHACS .
Mail a copy of your completed physical to Athletics.

If you live outside the United States and believe that you cannot meet the requirements of these health forms, please contact SHACS.

To better protect your private health information, don't scan and email your forms.

Health Insurance

All students are required to have a U.S. based Affordable Care Act compliant health insurance policy while attending Grinnell. You may choose to:

  • maintain coverage through your existing parental or personal policy, and/or
  • purchase the College’s student group insurance.

Review your existing insurance policy carefully  so you become familiar with what you policy will cover while you are at Grinnell. Policies vary widely in what they cover and in where they cover services.


  • Urgent Care in Grinnell bills insurance like a primary care provider. If your insurance only covers urgent care or emergency room visits, it will only cover emergency room visits in Grinnell.
  • If you participate in a health care plan such as Medicaid from a state other than Iowa, your plan will not transfer to Iowa.

Please contact the director of SHACS for additional direction.

Declining Student Group Insurance Plan

All students are automatically billed for the student group insurance plan. You will receive information from the Cashier’s Office on the benefits and limits of this plan.

To opt out of the plan, you must follow the instructions they provide by the date required.

  • For questions about what information you need to provide on the waiver form, contact Gallagher Customer Service.
  • For additional support in the waiver process, contact Grinnell College’s Cashier’s Office, 641-269-4100.
  • For questions regarding plan coverage please contact Dustin Smith at Ramsey Weeks, 641-236-3141.

Keeping Student Group Health Insurance

Unless you have confirmed that your current insurance provides excellent coverage for health and mental health services in Grinnell, we strongly recommend that you enroll in the student group insurance, which is widely accepted in the local and surrounding communities.

Some students elect to carry the student group insurance as a supplement to their parental or personal policy.

Note: The College does not benefit financially in any way when students purchase the student group insurance.

Services at SHACS

SHACS registered nurses provide health and mental health services to many Grinnell College students each year. With the exception of modest, at-cost fees for a few medical tests and supplies, these services are delivered free of charge.

SHACS also offers free psychiatric prescription services through tele-medicine and free on-site counseling. Any medications prescribed, however, are obtained through the student's insurance plan.

Complete information about our services, wellness programs, relaxation area, and staff can be found at Student Health and Counseling Services (SHACS).

Over the summer

Please feel free to contact SHACS with any questions regarding your health forms, SHACS’ services, and health and mental health services in the community and region.

Due to limited coverage during the summer, we ask that you please be patient; we will respond to you as quickly as possible.

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