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Health Record and Immunizations

Complete the Admission Health Record and Required Immunizations Form and submit it by May 1, 2019 (summer start) or July 1, 2019 (fall start).

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.