First Year Students - Immunization Record

The form MUST be completed, in its entirety, by a licensed Physician, Nurse Practitioner (NP) or Physician’s Assistant (PA).


Overview: The form MUST be completed, in its entirety, by a licensed Physician, Nurse Practitioner (NP) or Physician’s Assistant (PA). It CANNOT be completed by a family member. The complete physical examination must have been completed within 12 months prior to the date the student arrives to campus. TB screening is required as a part of this examination.

If you decline immunizations, you are required to sign a waiver. IMMUNIZATION WAIVER

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PDF Preview of 2018 Immunization form

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