Forms

The health requirements for the 2024-2025 Academic Year are contained within this document. Please note, Immunization Records are due prior to coming to campus. 

 

Please upload completed health forms to the Patient Portal.

 

 

(.pdf, 119K)

You must submit your physical exam and immunization records to Dexter Health Services prior to coming to campus.

 

Please upload completed documents to the Patient Portal.

(.pdf, 252K)

To be completed by all incoming students. Please upload the completed questionnaire to the Patient Portal and include your name and Student ID Number when submitting this form.

(.pdf, 293K)

Newly enrolled part-time students and newly enrolled full-time students 22 years of age and older should review the document titled Meningococcal Disease and College Students. 

(.pdf, 902K)

Students who are greater than 21 and do not live in on-campus residential housing may waive the meningitis vaccination. Please read, sign, and return the waiver to Dexter Health Services.

(.pdf, 399K)

Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year, and religious exemptions (statement from a student or parent/guardian, if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs), should be renewed annually at the start of the school year.  

Students requesting an exemption to the vaccination requirements for medical or religious grounds should complete this form in addition to the above statements.

(.pdf, 84K)