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Here are some of the forms used in the IUP Health Service that are available online.

For more information, contact us by e-mail or telephone.

Health History Form 

This form is given to all students at Orientation. You should mail, fax, or drop off this form to the Health Service (address at the top of each form) prior to arrival on campus, or upon arrival. This form should be completed by the student, with help from parents, as needed, for family history.

Immunization Certificate

This form is given to all students at Orientation. You should mail, fax, or drop off this form to the Health Service (address at the top of each form) prior to arrival on campus, or upon arrival. This form may be completed by a medical provider, or dates can be supplied from family records. Additional forms may be attached.

Application for Employment at the IUP Health Service

Students must have a driver’s license to apply for this position.

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  • Health Service
  • Center for Health and Well-Being
    Suites on Maple East
    901 Maple Street
    Indiana, PA 15705
  • Phone: 724-357-2550
  • Administration: 724-357-6475
  • Fax: 724-357-6212
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  • Spring Semester Office Hours
  • Monday through Friday
  • Patient care 9:00 a.m. to 4:00 p.m.
  • Admin hours 8:00 a.m. to 4:00 p.m.
  • Open during lunch hour
  • Closed weekends and major holidays