Click on the check list image below to be taken to a printable form.
For questions contact Susan Palmer at 585-245-6453, firstname.lastname@example.org
- 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,
Get Appointment Reminders!!!
- MMR-Dose 1 (Must be given AFTER your first birthday).
- MMR-Dose 2 (this MUST be minimum 28 days after the first dose).
Strongly recommended immunizations
- Tetanus- Diphtheria- Pertussis (Td, TDAP)
- Hepatitis A and B
- Gardasil (HPV)
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