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ABOUT UNIVERSITY WELLNESS SERVICES
Wellness Services provides comprehensive health and wellness services to Northwest students, including outpatient clinical services, counseling services, and wellness education and prevention programming. Wellness Services emphasizes self-responsibility and believes students should take an active role in maintaining their health. Our philosophy of care goes beyond quality outpatient care and considers the individual as an integration of mind, body, and spirit. Please visit www.nwmissouri.edu/wellness for more information.
UNIVERSITY WELLNESS & HEALTH INSURANCE
University Wellness Services has the capability to bill your insurance company for the services provided. If you have health insurance, please do the following:
- Submit copies of both the front and back of your health insurance card to University Wellness Services. You can attach them in this form.
- Contact your insurance company to make sure we are an in-network provider.
- We recommend that you do so before submitting this form, that way you can include this information in your form submission.
- Your insurance company will need the following information when contact them:
- Dr. Susan Watson
- 800 University Drive
- Maryville, MO 654468
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THIS FORM, AND IMMUNIZATION RECORDS, MUST BE COMPLETED AND SUBMITTED BY THE FOLLOWING DATES:
Fall Trimester – August 1
Spring Trimester – December 1
Summer Trimester – April 1
IMPORTANT TO KNOW:
Failure to submit this required information by these dates can result in a hold being placed on your account. If you have a disability or significant health problem, please contact Wellness Services before coming to campus. Additionally, if your problem does not allow you to easily fill out an online form, please also contact Wellness Services for assistance.
If you have any questions or concerns that arise while you are filling out this form contact University Wellness Services at 660.562.1348. You may also email University Wellness Services at: health@nwmissouri.edu.
Click the Next button below to begin filling out your health information.
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