New Students: Medical Checklist
Please fill out pages one and two of the Health Report, remembering to sign the consent for medical care. If you are under 18 when you arrive on campus, this consent needs to be signed by a parent or guardian. Please also answer the four questions on the Tuberculosis Risk Assessment Questionnaire (RAQ); and read and sign the Meningitis Waiver if you have not already received the Meningitis Vaccine or are not planning on receiving the vaccine.
MASSACHUSETTS COLLEGE IMMUNIZATION LAW mandates that all college students provide documentation of immunity for:
- MEASLES: Two doses of measles vaccine or MMR given at least one month apart and on or after 1st birthday
- MUMPS: Two doses of mumps vaccine or MMR given on or after 1st birthday. (Please note: Due to recent outbreaks of mumps disease, all students should have documentation of TWO doses of MMR vaccine OR serologic evidence of immunity)
- RUBELLA: Two doses of rubella vaccine or MMR given on or after 1st birthday.
- HEPATITIS B: Three doses of Hepatitis B vaccine; 2nd dose given 1-2 months after 1st; 3rd dose 4 -6 months after 1st. OR: A report documenting a positive immune titer for Hepatits B (titer values and interpretation must be included).
- TETANUS/ DIPHTHERIA: Vaccine (Td) or Tdap booster within the past 10 years
- MENINGOCOCCAL VACCINE: Massachusetts Law requires that all entering students receive meningococcal vaccine OR actively decline by signing the Waiver for Meningococcal Vaccination Requirement Form. For more information about meningococcal meningitis and the vaccine, please refer to www.mass.gov/dph or www.acha.org
- VARICELLA VACCINE (chickenpox): Two doses one month apart recommended if no history of disease.
- HUMAN PAPILLOMAVIRUS (HPV) VACCINE: Three doses at 0, 2 and 6 month intervals.
- TUBERCULOSIS SCREENING: All students must complete and return the Tuberculosis Risk Assessment Questionnaire (RAQ) and, if deemed to be at risk, a tuberculosis skin test (Mantoux / PPD), administered within the past 6 months, is required. History of prior BCG vaccine does not exempt testing. The test must be checked by a healthcare provider within 48-72 hours of being administered AND the result, in millimeters, must be recorded. If PPD is positive, a report of chest X-ray, taken within the past 6 months, is required. If you have been or are currently being treated for a positive PPD, please include beginning and end dates of treatment with INH (or if other medication, please specify).
Students are NOT eligible to practice or participate in intercollegiate sports until the Health Report Form, including a physical examination, clearance to participate and immunization documentation, has been completed and submitted to the Health Center.
Bring enough of your ongoing medications for the first month of school and bring a copy of the prescriptions with you. Plan ahead for refills. If you wear eyeglasses or contacts, bring a copy of your prescription with you.