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New Student Resources

Welcome to Seattle Pacific University! You are about to embark on an incredible life changing adventure. However, before beginning there are a few simple requirements to take care of with Health Services. Below you will find all you need. Any questions please feel free to call us during business hours (206) 281-2231.

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


Incoming Student Requirements:

Please note: Both the Medical History Record and Student Immunization Record 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. We do ask for a copy of your insurance card, front and back, (if you have one).

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) since 2005. International students must also have a current PPD completed in the U.S.

        Please note: With the epidemic levels of Pertussis in Washington, Tdap with 

        the adult dose of Pertussis is required of all incoming students.

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.

    Note: Meningococcal (Menningitis) is recommended and available at 

    our clinic, if your Healthcare Provider does not carry it.  

    Recommended immunizations are not required for students, but

    simply recommended by the CDC.

  • 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.


Insurance Information for International Students:

             LewerMark Insurance Company

                           Use this link to either find out about the policy. All International students are

                           required to have medical insurance. You are automatically enrolled in LewerMark,

                           unless you have provided proof of comparable insurance to the Health Services

                           Director within 5 days of the start to the current quarter. You must renew your

                           medical insurance waiver each time the policy is renewed.


  Copyright © 2015 Seattle Pacific University. Health Services: (206) 281-2231. 3307 3rd Ave. W., Seattle, WA 98119