Health History Form

Health history forms must be completed and signed by the student’s healthcare provider by June 30. 

• Step 1: Read your Welcome Letter Summer ’18 for important dates and information!
• Step 2: Complete pages 2-3 of your 2018 Student Health Form and have your healthcare provider complete page 1 OR attach an official copy of your vaccination records to your health form.
• Step 3: Fax or mail your completed Health Form and vaccination records to the Student Health Center by June 30.

PLEASE NOTE: Failing to complete this form in time will result in a medical hold that will restrict you from registering for classes for next semester.

Immunization Requirements

Immunization requirements, based on recommendations of the American College Health Association, are required for every full-time day undergraduate student and any residential student (graduate or other programs).

Required vaccinations include:

• 3 doses of DPT and tetanus booster (preferably Tdap) within the last 10 years;
• 2 doses of MMR (measles, mumps, rubella) vaccine if born after 1956 OR positive blood tests tests for IgG titers;
• 3 doses of hepatitis B vaccine or a positive blood test for hepatitis B surface antibody titer;
• 2 doses of Varicella if born after 1979, history of chickenpox disease, or a positive blood test for Varicella IgG titer;
• Tuberculosis testing (PPD, T-Spot, or Quantiferon Gold) for all nursing majors, education majors, and students living in high risk countries (S. America, C. America, Africa, Asia, E. Europe and parts of W. Europe);
• Meningococcal Meningitis Vaccine(Type A, C, W-135, Y) or a signed waiver of declination;
• Type B Meningitis Vaccines is recommended but not required.

Most vaccines are available at cost from the Student Health Center.