Health Forms

• Health Form
• Meningitis Form
• Medical Records Release
• Medical Transport Request

• Syracuse University Health Services strives to provide you with the most comprehensive and effective health care possible. To meet this goal it is important for us to obtain an accurate health history for each student. Please assist us by filling out the attached health history form as accurately and thoroughly as possible and return it with your immunization records by June 1, 2012.

  Immunization Requirements

  Syracuse University is obligated to enforce student immunization requirements as defined by New York State public health law.

  Proof of immunity to measles, mumps, and rubella includes:

  • Dates of two doses of measles vaccine after one year of age, positive titer results, or physician documentation of disease
  • Date of one dose of rubella vaccine, or positive titer result and
  • Date of one dose of mumps vaccine, or positive titer result, or physician documentation of disease.This information may be obtained by contacting your high school or primary care physician. Immunization records may be faxed directly to Health Services at 315-443-9010.

  A completed meningococcal meningitis vaccine response form must be provided to Health Services indicating that the student, parent or guardian has received and reviewed meningitis information, and that the student has either been immunized within the preceding 10 years or has opted not to obtain immunization against meningococcal disease. 

  If these documents are not received by Health Services prior to arrival on campus, students will risk strict administrative consequences including the inability to register for classes and/or suspension of ID card services.

  For more information on immunization exemptions, click here.