Resources
Prior to being on campus ALL students (new enrollment or
transfer) must complete and submit the mandatory Medical History
Form to:
Lock Haven University
Glennon Health Services
401 N. Fairview St
Lock Haven, Pa. 17745
We strongly urge you to make copies of this form.
The form includes:
• Personal history
• Physical examination
SIGNED by Primary Care Physician
• Immunization record
• Insurance information
Please note that certain areas of study may have different
laboratory test requirements. Please consult your major to
verify that you have all necessary immunizations and tests that
are needed to fulfill the major requirements.
Release of Information
Any student, age 18 years or older, must come to the Student
Health Service office and complete a written record release to
obtain any medical records. This includes release of information
to:
• Parents
• Physicians/specialists
• Coaches
• Trainers
• Employers
• Universities
• Other
Depo Provera Injections
Glennon Health Services nursing staff can administer DepoProvera
injections IF:
• Evaluation and initial injection was previously done by a
Primary Care Provider
• Physician Assistant is on-site
• Student comes to Student Health Services during the dates
indicated from prior injection
• Student brings documentation from Primary Care Provider of
last injection date
• Student brings original prescription, in its unopened
container, from the pharmacy
• Student is free of side effects or problems prohibiting the
use of DepoProvera
• Student Health Services is not responsible for any costs
incurred from any pharmacy for a DepoProvera injection. |