Required Health Information & Alcohol Wise Program

Health Forms | Alcohol Wise

Due Dates for Required Health Information

• July 1st for fall enrollment
• January 15th for spring enrollment

All new students enrolling at Keene State College are required to complete a Comprehensive Student Health Form (CSH form), an immunization report, a Physical Form, and a Tuberculosis screening form.

The CSH form and your immunization dates are completed electronically through a student portal and the remaining forms must be printed, completed by you and your Primary Care Provider and mailed or faxed to us.

Health Forms

Log onto KSC on line student health at https://ksconlinestudenthealth.keene.edu/. (This program will become available to you once you have been registered for classes.)

1. When you click on the link above you will be directed to a Keene State College authentication page.
2. Enter your netID and password which was given to you by the college.  (hint it is usually your first initial and last name)
3. After the system has verified you as a KSC student, you will be directed to the home page of the On-Line Student Health program.
4. Click on the health history link on the left hand side. ALL KSC STUDENTS are required to complete this form.
5. If you are planning to play a competitive sport while a student at KSC, you must also complete the other two medical forms.
6. Finally, ALL KSC STUDENTS must click on the Immunization link that is below the medical history. Using your immunization records from your PCP or your high school, enter the dates of the immunizations you have received.
7. After submitting that information, please mail or fax a hard copy of your immunization to us for confirmation. We recommend that you keep a copy for your own records. You will not be considered compliant until we can verify the information you have submitted.
8. Once you finish these forms, they will automatically become part of your medical record.
9. Print the Physical Examination Form, and Tuberculosis Screening Form from the links below. Fill in your personal demographic information and forward these forms to your Primary Care Provider (PCP) to complete. Your PCP may return these directly to us but it is your responsibility to ensure that happens. You may use your most recent physical to complete the physical form.

Physical Forms

Print the Physical Examination Form, and Tuberculosis Screening Form from the links below. Fill in your personal demographic information and forward these forms to your Primary Care Provider (PCP) to complete. Your PCP may return these directly to us but it is your responsibility to ensure that happens. You may use your most recent physical to complete the physical form.

• Physical Form
• Tuberculosis Screening Form

Mail or Fax the completed physical and TB screening form to:

Center for Health and Wellness
Keene State College
229 Main Street Keene, NH 03435-2802
(603) 358-2450
(603) 358-2444 (fax)

Alcohol-Wise Program

Due Dates for The Alcohol-Wise Course

• Available on July 26, 2013
• Must be completed by Aug. 15, 2013

Alcohol-Wise is an online alcohol education course that is a required assignment for all first year students to complete prior to coming to Keene State College. You will need access to a computer connected to the internet and your Keene State College e-mail address.

The ALCOHOL-WISE has a follow up component that must be completed 60 days after you complete the course. You will receive a reminder email regarding the follow up component of the program.

To receive credit for this program you must follow enrollment instructions and enter the control number: KSCAW.

1. Go to www.3rdmilclassrooms.com
2. Click on Begin Enrollment-College on the left side menu.
3. When you are directed to enter the Control Number, enter the code: KSCAW.
4. You will receive a password immediately on the screen and by email.
5. Login using your email address and password to begin the course. The course takes about one hour to complete and you can login and out as needed.
6. You will receive an email in 60-days reminding you to complete the 15-minute mandatory follow-up.
7. Keene State College will receive an email notification after you complete the course and the follow-up.
8. Print out a copy for your records.

For questions or problems regarding the course, please email the Center for Health and Wellness at chw@keene.edu or call at 603-358-2450.