Wellness Forms

To ensure a healthy campus and to comply with State of Illinois requirements Dominican University maintains the following health requirements:

  • All students taking six or more hours must supply the Wellness Center with a authorization_for_release_of_health_information_online_form.pdf that will meet state requirements before the first day of classes each semester.
  • Students who fail to comply with the immunization reporting requirement are subject to a fine each semester they fail to comply.
  • To ensure the highest possible level of care and safety, all students are urged to complete and submit a health history no later than July 15 (for fall semester) and December 1 (for spring semester).
  • Students must complete a waiver at www.dominicaninsurance.com or they will be automatically enrolled in the student health plan and charged to their student account at a cost of $925 for the fall semester, $1850 for the year, and $1175 for spring/summer only.  Early enrollment in the student health plan is $165 a month.  

Health Forms should be submitted to the Wellness Center by fax (708) 488-5072, email: wellness@dom.edu or mail: Wellness Center,  7900 Division, River Forest, IL 60305, or students may drop their records off at the Wellness Center in person. There is a secure Drop Box in the door adjacent to the Wellness Center for health forms which is accessible up to 10pm daily.