Medical Records & Forms

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

An electronic version of the form will soon be available. You may also download and complete a paper form now — either version is acceptable.

Bucknell requires all students to be up-to-date with COVID-19 vaccines. Documentation for any student who is not currently submitting a medical record form should be sent to medicalrecords@bucknell.edu

For questions about Bucknell's COVID-19 vaccination requirement, please see the COVID-19 Vaccination FAQ.

Due Dates 

  • First-year and incoming graduate students: June 15, 2022
  • Students returning from a leave of absence or being readmitted: June 6, 2022
  • Summer Session students: June 6, 2022

Required Immunizations

Bucknell requires are students to have the following immunizations. Students are required to submit documentation of being up to date with the COVID-19 vaccine by Aug. 1, 2022. Additional information about vaccinations and dates of administration can be found in the medical record form.

  • Hepatitis B**
  • Measles, Mumps, Rubella (MMR)
  • Polio (OPV or IPV)**
  • Tetanus/Diphtheria/Pertussis (Tdap) or booster
  • Chicken Pox (Varicella)**
  • Meningitis (Meningococcal vaccine – A,C,Y, W-135)
  • Meningitis Serogroup B series (Meningitis and Meningitis B)
  • COVID-19 vaccine and CDC-recommended boosters

**Graduate students using an outside primary care physician and non-degree students are not required to have these immunizations.

Forms & Instructions

Additional Forms for Varsity Athletes 

In addition to completing the appropriate Bucknell Medical Record form, varsity athletes must submit additional medical forms to the NCCA to qualify for athletics participation.

As soon as you receive your ARMS software account from the Bucknell Compliance Office, please check it to access all forms assigned to you (my.armssoftware.com/arms).

  • Pre-participation physical and sickle cell test results
  • First-year medical history questionnaire
  • ADHD form (required for those who are prescribed ADHD medication)
  • Concussion education acknowledgement and baseline testing form
  • Medical insurance and injury responsibility form 
  • Emergency contact and general information form
  • Sports medicine signature forms

Completed medical forms for NCAA Athletics Participation must be submitted through the ARMS software account. Substitute forms will not be accepted for athletics participation. Forms will be checked by a member of the athletics training staff and will be approved or rejected. If rejected, the student will be notified with a message sent to their @bucknell.edu email address regarding the reason so it can be rectified. Even if a form is approved, a staff member may be in touch with more follow-up questions if needed.

Additional documentation/medical records might be requested depending on some of the answers you provided. The initial due date for sports medicine forms is June 15, 2022. If you have any questions while completing the form, please email sports-medicine@bucknell.edu


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-2013 Graduates

Current students and alumni who graduated after spring 2013 should use the following form to request copies or release of medical information.

  • Request for records related to treatment after spring 2013 should be submitted to medicalrecords@bucknell.edu. Please complete the Geisinger release form.
  • Request for records related to treatment prior to spring 2013 should be submitted to the Dean of Students office. Please note paper charts are kept for 7 years, and then are destroyed.

Contact Details

Bucknell Student Health

Location

Graham Building, enter from 7th Street

Hours

Monday–Wednesday: 8:30 a.m. – 4:30 p.m.
Thursday: 10:00 a.m. – 4:30 p.m.
Friday: 8:30 a.m. – 4:30 p.m.
Saturday–Sunday: 10:30 a.m. – 2:00 p.m.