Loyola University Chicago

John Felice Rome Center

Medical History Report

Every student attending the Rome Center must fill out the health self evaluation form before arriving at the JFRC.  This form may be filled out through the online application system. Please provide as much information as possible about your medical history.  This form is confidential and will allow the Rome Center staff sufficient time to make any necessary preparations to accommodate student needs. (i.e. dietary restrictions, food allergies, medication regimen, learning disabilities)