Forms and Immunization
- Health Information Form (Required)
- Immunizations (Required)
- Hepatitis B Fact Sheet
- Meningococcal Meningitis Fact Sheet
- Medical Release Authorization
- Religious Exemption
- MMR: All students born on or after January 1, 1957, must provide proof of immunization with two doses of MMR vaccine at least 28 days apart (OR) serology showing immunity to MMR.
- Varicella or Chickenpox: All students born on or after January 1, 1980, must provide proof of immunization with two doses of Varicella vaccine at least 28 days apart, (OR) serology showing immunity to Varicella, (OR) documentation from a medical facility verifying a previous diagnosis with the illness.
- TB: All incoming students taking classes on campus must submit either a PPD or an IGRA (Quantiferon Gold or Tspot) result dated within the last 6 months (OR) chest Xray results and/or treatment completion certificate, as appropriate.
- Hepatitis B: All students must either provide proof of immunization with three doses of Hepatitis B vaccine (OR) documentation of serology showing immunity to Hepatitis B virus, (OR) having read the provided Hepatitis B information sheet, initial and date the immunization form indicating the desire to waive the vaccine, understanding said risks/benefits.
- Meningitis: All students must either provide proof of immunization to Meningitis/MCV4 (received the vaccine at 16 years of age or older), (OR) having read the provided Meningitis information sheet, initial below indicating the desire to waive the vaccine, understanding said risks/benefits.
The Student Health Insurance form is available from Risk Management.