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Incoming Student Requirements:

The following two forms are required of all incoming undergraduate, international and Health Sciences students.

Downloadable Forms:
          Student Immunization Record (PDF)
          Medical History Record (PDF)

Please note: Both forms must be complete and turned in to Health Services in order to register for classes. If you are missing just one part (i.e. a Tdap), you will have a "Health History Hold" until your file is complete.

Medical History Record
3-page self-report form, filled out and signed by the student. No need for doctor signature.

Please Note: This is NOT the "Medical History Form" athletes have to fill out for Athletics.

Student Immunization Record

  • 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). 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: Recommended immunizations.
  • Part Four: Travel Immunizations. Travel immunizations are not required. However, if you participate in a cross-cultural experience, you may need the documentation. Sometimes it is easier to ask a healthcare provider for all your immunizations at once, rather than in pieces during deadlines.


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