1. Completed Immunization Record Form (link below) with physician stamp or signature OR your healthcare provider may attach a copy of your immunization records from your physician’s office.  Please see list of required immunizations on Immunization Record Form below.

The State of North Carolina mandates that all students must provide their immunization records to the school they are attending. If this requirement is not met or not in process of completion, dismissal from school 30 days after registration is mandatory under North Carolina law.

  1. Medical History form to be completed by the student or parent (link below).


3. Physical Exam form which is highly encouraged for new incoming students to be completed by their physician prior to attending Belmont Abbey College.

Required forms are due by July 1 for the Fall Semester and December 1 for the Spring Semester.

**Student Athletes: These forms are in ADDITION to the forms required by the Athletic Department.  Our forms are different and both are necessary. Below the links to the required Wellness Center forms is a link to the Athletic Trainer’s required forms.

Immunization Form
Student Medical History Form
Physical Examination Form
Forms for athletic trainer


Athletes:   Click here for required forms for athletic trainer

Please return all completed forms by mail, email or fax to:

Wellness Center
Belmont Abbey College
100 Belmont – Mt. Holly Road
Belmont, NC 28012
Fax:   704-461-6878

If you have any questions, please contact us between 8am-4pm Monday-Friday.

Please note: Summer Hours during June and July will be limited.

Thank you,

Wellness Center Staff
Belmont Abbey College
(704) 461-6877