Listed below are the health forms that need to be completed to meet the requirements for registration.In an effort to facilitate your health clearance at future clinical sites and to fulfill the requirements of the New York State Department of Health Code, these forms must be completed and kept on file in the Employee/Student Health office. Your record will be reviewed by the Student Health personnel, and if necessary, referred to the Medical Director for further evaluation prior to clearance.
If you have difficulty accessing the information in these forms, please contact the Office of Student Health at 315 464-5470.
Student Health Form This form is to be completed by the student with each item being checked and an explanation for all "yes" answers in the space provided. You may use an additional sheet, if necessary. Your health care provider needs to complete the summary section, sign and date.
All sections of this form are to be completed by your health care provider, with each item marked individually (no lines through will be accepted). The forms must be signed, dated and stamped by your health care provider and include address and phone number.
Student Immunization Form
All sections need to be completed by your health care provider.
Laboratory testing for antibody titers is required and copies of the laboratory report must be returned with the form. Dates of immunization alone are not acceptable.
Please note: Tuberculin skin test should not be done. This will be placed, on campus, before registration.
