New/Transfer Student Immunization Compliance

Click on the check list image below to be taken to a printable form.

Immunization Form    Physical Form

For questions contact Susan Palmer at 585-245-6453,


2019-2020 deadlines

Your electronic immunization and physical forms must be submitted to by the following deadlines.

  • First-year/Transfer students entering in the fall semester:  Extended to July 15
  • Summer Program attendees:  June 21
  • Students entering in the spring semester:  January 21
  • ** Physical within past 12 months,
    • Transfers within 24 months
    • Potential Varsity Athletes within the last 6 months. Additional information to be completed at  Sports Medicine in the  Medical Forms section.


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Required Immunizations

  • MMR-Dose 1 (Must be given AFTER your first birthday).


  • MMR-Dose 2 (this MUST be minimum 28 days after the first dose).


  • Meningococcal


Strongly recommended immunizations

  • Tetanus- Diphtheria- Pertussis (Td, TDAP)


  • Hepatitis A and B


  • Gardasil (HPV)


  • Varicella


What is an Acceptable Immunization Record

A copy of your immunizations (including actual dates) on an official government/school letterhead — the simplest place to obtain this may be from your most recently attended high school or college; OR

A copy of your immunizations (including actual dates) on physician’s letterhead with dated Doctor/Provider signature, which includes printed name, address and telephone number; OR

Have a blood test to confirm immunity. Please note: a copy of the lab report must be provided to Student Health Services.

Please note that the documentation must be in English and must have students name and date of birth