Medical Records & Forms

Medical Record Form

All incoming students are required to submit a medical record to Bucknell Student Health prior to arrival on campus.

Due to the global COVID-19 pandemic, we understand that some students may not be able to get updated vaccines and physicals to meet Bucknell's requirements by the June 15 deadline.

If you can get your physical examination, TB test, and any missing or updated vaccinations, please do so and then send in your completed medical record.

If you cannot get them, we ask that you send in your medical record with your most recent vaccination record and physical exam. We will then work with students on what they need to do to get these requirements completed.

Please call Student Health at 570-577-1401 with any questions you have concerning your medical record.

Due Dates: Medical forms should be submitted no later than:

  • June 15 for fall enrollment.
  • January 3 for spring enrollment.
  • May 28 for summer enrollment.

Release of Medical Records

Bucknell Student Health is required by government regulations to receive written permission from a student before sharing any medical information with other health providers (for reasons other than continuation of care). This written permission is also needed for any disclosure of information to a student’s parent/guardian. In order for Bucknell Student Health to release your medical information, you must provide a written request.

Please be aware that any information release that is not sent directly to another physician/medical facility for continuation of care cannot be faxed or emailed. It must be sent through regular mail or picked up by the patient. Authorization forms for release of information may be obtained below or at the Student Health office.

Current Students and Post-2012 Graduates

Current students and alumni who graduated after spring 2012 should use the following form to request copies or release of medical information.

 

Bucknell Student Health

Location

Graham Building, enter from 7th Street

Hours

Monday – Friday: 8:30 a.m. – 4:30 p.m., Except Thursday
Thursday: 10:00 a.m. – 4:30 p.m.
Saturday - Sunday: 10:30 a.m. – 2:00 p.m., During regular semester