FORMS AND INSURANCE
- Immunization Form (pdf)
- Personal Health History (pdf)
- Physical Examination Form (pdf)
- Nursing Program Immunization & Clinical Compliance Form
- Disability Support Services Application (pdf)
- Letter for New DSS Students (pdf)
Rockford University is committed to ensuring the availability of basic health care to all students and follows the basic minimum requirements as determined by recent health care reform.
The student health insurance plan is provided through Student Assurance Services, Inc. located in Minneapolis, Minnesota. All full-time students, residential students, nursing students, education students, international students and those who participate in intercollegiate athletics are required to have adequate health insurance coverage as well as meeting other requirements determined by his or her program of study. Student Assurance Services, Inc. provides a health insurance plan for our students that is designed to meet the individual or group insurance minimum standards as required by health care reform law.
Students who wish to purchase health insurance through the student plan may do so by accessing the insurance brochure and enrollment form below or at the CHP Student Health website https://studentinsurance.com/Schools/?Id=896. If you want to enroll in the student insurance you must do so before the end of the second week of classes.
Students who have personal health insurance coverage may waive the health insurance charge by completing the on-line waiver. Waiver information can be found below or at the CHP Student Health website https://studentinsurance.com/Schools/?Id=896.
In order to have the health insurance charge waived on your student account you must complete the insurance waiver before the end of the second week of classes. Waivers submitted at any other time will be invalid and will not be accepted. A waiver must be submitted your first semester at Rockford University and every fall semester thereafter. Waivers and enrollments must be completed by the end of the second week of classes for each semester.
- Insurance, enrollment and waiver information is required by all full-time students for 2018-2019
5050 E. State Street
Rockford, IL 61108
Walk-in hours: Mon- Fri - 10:00 am to 4:00 pm
Other hours are available by appointment
Physician available by appt - Tues afternoons
Patients must make appointments for the physician or counseling services
Walk-in hours: Tues-Thurs - 10:00 am to 2:00 pm
Mon & Fri - Closed
Other hours available by appointment