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Health Record and Immunizations

Complete the Admission Health Record and Required Immunizations Form and submit it by July 1, 2019.

Mail the completed form to:

Northwestern University Health Services
Health Information Management Services
633 Emerson Street
Evanston, IL 60208

If you have questions, visit Northwestern University Health Services or call 847-491-8100. Failure to submit this form will delay your registration.

 

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