Health Forms, Records and Immunizations
Health Records
All full-time undergraduate students, and full-time graduate students in the Physical Therapy, Physician Assistant, Genetic Counseling, Forensic Science and International Peace and Conflict Resolution programs, are required to complete the Health Record before their arrival on campus. In order to be seen in Student Health Services, other than on an emergency basis, the completed Health Record must be on file. Prospective students should receive these forms shortly after submitting their deposit. The forms are also accessible through this website. Part-time students and students in other graduate programs not mentioned, are welcome to use Student Health Services for a $35 per visit fee, if they have submitted a completed Health Record.
Part-time undergraduate students and students in other graduate programs are required to submit a Health Record only if they wish to access health services. Any student without a Health Record on file will be seen for emergencies only.
The Health Record is composed of student identification information, medical history, physical examination (to be completed by a physician, nurse practitioner, or physician's assistant), and immunization record. The physical exam must have been performed within the past 12 months. This information is confidential, for use by Student Health Services personnel only. Documentation of insurance information is also required.
Required Immunizations
The immunizations listed below are required. In the event that the student cannot obtain documentation of immunization, the student will either have to be re-immunized or have laboratory verification of immunity. If needed, immunizations and titers can be done in Student Health Services for a reasonable fee.
- Tetanus (within the last 10 years)
- Measles (2 doses required)
- Mumps
- German Measles
- Meningitis*
- PPD (Tuberculosis screening)must be done within six months of college entrance
- Hepatitis B (3 doses required)**
* As of July 2002, Pennsylvania law requires that all students residing in a college/university-owned residence hall or housing unit either have the meningitis vaccine or sign a declination statement after having received information concerning the benefits of receiving the meningitis vaccine. The meningitis waiver is available on the Immunization Record of the health form. It is also available in PDF format and can be downloaded using Adobe Acrobat Reader or may be obtained at Student Health Services.
** It is understood that the Hepatitis B series may not be completed upon arrival on campus because of the time sequence in which the vaccinations need to be given. The student must submit documentation of each injection as it is received. For more information, call (215) 572-2966.
