Health Services Forms

Part-time & Full-time Students

All students are required to submit immunizations records.

Download the following forms:

• Student Information
• Immunization Record Form - Page 1
• Immunization Record Form - Page 2
• Fee Schedule

Once completed, submit these forms to the Health Services office.

Allied Health Students

All students enrolled in Allied Health programs including Nursing, Dental, Phlebotomy, Massage Therapy, Medical Assistant, Certified Nurse Aide, EMT, and Paramedic are required to submit a physician's certification that the student has received the required immunizations.

Download the following forms:

• Student Information
• For the Health Care Professional
• Imunuization Hot Sheet
• Physical and Mental Criteria
• Physical Exam Form
• Fee Schedule

Once completed, submit these forms to the Health Services office.