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Health Forms

mandatory forms

  • DEADLINE FOR SUBMITTING HEALTH FORMS:  FALL ENROLLMENT:  AUGUST 1ST
  • DEADLINE FOR SUBMITTING HEALTH FORMS:  SPRING ENROLLMENT:  JANUARY 1ST

IMMUNIZATION REQUIREMENTS

  • completing The Connecticut State University Student Health Services Form is mandatory for ALL students including online and transfer students.

  • Connecticut state statutes requires that ALL incoming students MUST provide proof of THESE vaccinations.

  • You WILL NOT be able to move in OR attend classes without this form.

  • THE only exception to vaccination policy: entirely online STUDENTS

  • be sure to complete the entire form, especially the questionnaire regarding tuberculosis.  

  • incomplete forms will not be processed

FOR RESIDENTIAL STUDENTS:

  • 2 DOSES of MMR (measles, mumps, rubella) vaccine. 1st dose given on or after the first birthday second dose at least 28 days after 1st dose. 
  • 2 DOSES of VARICELLA (chicken pox) vaccine. (Required if born on or after January 1st, 1980.) 1st dose given after the first birthday second dose at least 28 days after 1st dose OR  Proof of having the varicella disease (chicken pox) as a child.
  • MENINGOCOCCAL MENINGITIS WITH CONJUGATE VACCINE  (Protects from meningococcus A, C, Y, and W-135). Vaccine must have been given within five years of starting at SCSU. For students starting in Fall 2017, vaccine must have been given AFTER August 1st, 2013 to be considered current.
  • Those who don’t have access to their immunization records may submit lab reports (TITERS) which will provide laboratory proof of immunity
  • ADDITIONAL RECOMMENDED VACCINE FOR RESIDENTIAL STUDENTS:
    • SEROGROUP B MENINGOCOCCAL VACCINE. Protects against Serogroup B meningococcal disease, which is different from the other serogroups. This is not mandatory but is highly recommended for ages 16 through 23 for those living on campus.

 FOR STUDENTS LIVING OFF CAMPUS:

  • 2 DOSES of MMR (measles, mumps, rubella) vaccine. 1st dose given on or after the first birthday second dose at least 28 days after 1st dose. 
  • 2 DOSES of VARICELLA (chicken pox) vaccine. (Required if born on or after January 1st, 1980.) 1st dose given after the first birthday second dose at least 28 days after 1st dose OR  Proof of having the varicella disease (chicken pox) as a child.
  • Those who don’t have access to their immunization records may submit lab reports (TITERS) which will provide laboratory proof of immunity.  

The only exceptions TO THIS POLICY are:

  • Those born before January 1, 1957 for MMR,

  • Those born in the United States before January 1, 1980 for varicella.

  • Those with a valid medical exemption signed by their healthcare provider. Immunization Waiver (pdf)

  • Those who provide a written statement that immunization is contrary to their religious beliefs.

  • Those with documentation from a physician or director of health that the student has had a confirmed case of such disease.

  • Documentation must be submitted to the University Health Service prior to moving into campus residence facilities. The university reserves the right to deny registration  and campus housing to any student not in compliance with the above health requirements. 

    additional forms