Health Forms
To facilitate the care of health problems arising during the course of a student's attendance in school, the SHS obtains a complete record of previous medical history of each incoming student (matriculated as well as non-matriculated) along with the record of a recent physical examination performed by the student's family physician. Immunity to measles, mumps and rubella is required by New York State prior to matriculating at SUNY Downstate Health Sciences University. Proof of such immunity is described in the Student Health Form to be filled out by both student and his or her physician. Students will not receive clearance to register until the Health Form is filled out completely and properly.
The student health form is available as portable document format files (PDFs):
- Part 1: Immunization and Laboratory Record Form
- Part 2: History and Physical Examination Form
- Part 3: Meningitis Vaccination Response Form
In order for you to be sent to clinical sites for your educational training, the Student Health Service must provide the sites with information regarding your health. Without this signed form, the Student Health Service cannot provide health clearance to clinical sites, and you will be unable to do your clinical rotations and educational training. A health information waiver form is also available for download (in pdf format):
- Health Information Waiver Form (13K, 1 page)
- Hep B Consent Form - only for students declining hepatitis B vaccine
Visiting Students
Visiting students must have the following health form completed by their health provider and submitted as directed on the form.
For Visiting Medical Students, see also the Office of the Registrar.
Preventive Medicine — Continuing Students Only
In addition to the required vaccines mentioned above, students are required to have had polio vaccine, a recent tuberculin test, and tetanus/diphtheria or Tdap booster within ten years. Students are encouraged to be immunized against influenza and hepatitis B. For those students who will have contact with blood or body fluids during their studies, hepatitis B vaccination (or written declination) is now required. The SHS provides many routine vaccines free of charge, including the varicella (chicken pox) vaccine.
All continuing students are required to fill out and sign an annual health evaluation form and those students with a history of negative tuberculin skin test or IGRA will also be required to have the test repeated annually.