Health Services Immunization Form

Part-time & Full-time Students

All students are required to submit immunizations records.

Download the following forms:

• Student Information
• Immunization Record Form
  

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

Health Science and 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
• Imunization Fact Sheet
  
• Physical Exam Form

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