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Required Medical Forms

Parent Tips:


Tip 1: 
Make your doctor's appointment early to be sure to meet the deadlines.

Tip 2: Before waiving this insurance, check your current coverage to ensure adequate coverage of local providers in Charlotte, NC.

Tip 3: Student health insurance waivers must be completed yearly.

The Queens Health & Wellness Center supports the medical and mental health of our students year round.  The information on the required medical forms allows our staff to provide exceptional care to our students.   

For fall admits, the Student Medical Forms should be brought with you to the Summer Orientation sessions in order to participate.  All medical forms must be completed by August 1 to avoid a $100 late fee.

For spring admits, all medical forms must be submitted by January 5, 2015 in order to avoid the $100 late fee.  Students who are not in compliance within 30 days of the first day of class will be removed from their classes, removed from their residence hall, and there will be no tuition refund.

Student Medical Form
The first page of the form contains all necessary requirements and contact information.  Please follow instructions carefully.

Students who plan to play intercollegiate sports must send this completed form to the Health and Wellness Center in addition to any Athletic requirements. Our requirements are different and BOTH are necessary.

Transfer students must complete the medical history portion of this form and may request and forward copies of health/immunization records from the institution in which previously enrolled.

Health Insurance

Queens University of Charlotte requires all full time traditional undergraduates students to carry individual health insurance.  Students will be automatically enrolled under the Queens Plan, provided by United Healthcare.  Students who do not wish to participate in the Queens Insurance Plan, may waive this coverage AFTER December.  Students have until January 30 to waive the Queens health insurance.

To Waive your Insurance, you will be asked for the following information:

  1. Date of Birth
  2. Student ID Number
  3. To find your Student ID #:
    -On myQueens home, Select Academics
    -Log In to the Academic Portal
    -Next to your Name on the home page, select Personal Info
    -Select Academic Info - Your student ID # is on the right.
  4. Information from your current health insurance (have your insurance card available)

Please print the waiver confirmation email and keep for your records.

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