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 Downloadable Forms:
  Immunization Record (PDF)

  Medical History Record (PDF)

 

Helpful Links:
  Portal Step-by-Step Help

 

Incoming Student Requirements:

All incoming undergraduate and international graduate students must complete BOTH documents below as part of the admission to the University process. These need to be submitted in their entirety to Health Services in order to prevent a "Health History Hold" on your Banner account.

Document One: Medical History Record

       Option One: Fill out the downloadable form (see left). It's a two-page

       self-report form, filled out and signed by the student. No need for

       doctor signature. Fax number and USPS address are on the form.

       Option Two: Use the Online Portal to submit electronically into

       our secure system. You will need your SPU credentials. (Your

       username and password used for your SPU email)

       Patient portal:  https://spu.medicatconnect.com

Document Two: Student Immunization Record

Option One: Fill out the downloadable form (see left).

  • Part One: Filled out by the student
  • Part Two: Documentation of (a) 2 MMRs (usually given around 1 year and 5-10 years old); and (b) a Tetanus, Diphtheria, & Acellular Pertussis vaccine (Tdap) within 10 years. International students must also have a current PPD completed in the U.S.

     

Documentation can be provided in a number of ways:

    1. Your Health Care Provider can fill in the form;
    2. Copy of shot card or official documentation;
    3. Copy from high school (i.e. official transcripts or Certificate of Immunization);
    4. Copy of current college's form.
    5. If you do not have any of the above options, you may receive a blood test (Rubeola, Rubella, and Mumps Titers) to prove MMR immunity and update your Tetanus-Diphtheria.
  • Part Three/Four: Recommended immunizations. Not required, but helpful if you are going to study abroad as an SPU student.

Option Two: Use the Online Portal to submit electronically into

       our secure system. You will need your SPU credentials. 

       (Your username and password used for your SPU email)

On the portal, please enter the dates of your immunizations then upload your supporting documentation. Include your name and date of birth on all documents you submit.

Patient portal:  https://spu.medicatconnect.com


 
     

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