The Student Health Record needs to be completed before registration, or bring it with you to turn in on your registration day. If you have trouble completing the form, please check this web site, if you still have questions, please leave a detailed message and we will return your call.
The form needs to be completed by all full time day students, those living in campus housing, and by all students in a "health career clinical field". Transfer students still need to fill out the front page, page three and request your immunization record and physical from your last school.
The first page gives us demographic, emergency numbers, and insurance information. There is a place inside to attach a copy of your current medical insurance card. If the insurance changes, make sure your student has a current card to carry with them.
The second page information is mandated by our state law, by the Indiana State Board of Health, and by the Center for Disease Control. Your high school should have some of these immunizations on file; you must call and request a copy. You will need these records when your student has their physical.
Students will need to update the Tetanus vaccine, make sure you have had two doses of MMR, have a TB skin test placed and read, and start the Hepatitis B vaccine. You will also want to consider the Meningitis vaccine; we also want to know if students have had the Chicken Pox (Varicella) and the Polio vaccines as children. If not, you will need to update these as well. You may do this through you own healthcare provider, an urgent care facility, or through the Student Health Center during the first week of school. If all your student needs are immunization updates and you want it done on campus, please indicate that on the record.
The American College Health Association and the Center for Disease Control (CDC) have been recommending both the Hepatitis and Meningitis vaccines for a few years. It is now law in Indiana that kindergartners receive the Hepatitis vaccine, so we are requiring it to catch up your age group to protect your liver. The CDC has recommended that your healthcare provider inform college bound students of the risk of these diseases and start the Hepatitis B series. The Meningitis vaccine is highly recommended, but not required at this time.
The Student Health Center has all vaccines available to you for a special fee:
Hepatitis B: consists of 3 shots over a 6-month period of time. We give the adult dose, and will continue the series if started. Fee is $45.00 for each shot.
HPV Vaccine Gardasil: consists of 3 shots over a 2 to 6-month period of time. Fee is $125.00 for each shot
Meningitis Vaccine (Menomune / or Menactra): consists of a one-time dose. Fee is $100.00.
Tetanus (Tdap): should be boosted every ten years, sooner if a wound occurs. Fee is $45.00.
Tuberculosis (TB) PPD skin test: required of all incoming students within three months of starting school. Fee is $5.00, student must return 2-3 days later to have test "read" (arm checked) to be valid.
Measles/Mumps/Rubella (MMR): IN requires two doses of this if date of birth is after 1956. Fee is $60.00.
Please mark the Student Health Record if you want certain immunizations done at school. Your student will need to come and receive these vaccines when school starts.
The bottom of the second page asks for some social history about your student and the family. Please fill in all lines.
The physical is to be completed by all freshmen who are not athletes. Athletes will receive the mandatory physical from our athletic program. Please check the box and write in the sport your student will participate in. The physical needs to be completed by a licensed healthcare provider who is not your parent. If you do not have a current healthcare provider, our nurse practitioners can schedule a physical ($55.00 + shot fees) by calling our office and leaving a message. The physical can be scheduled in the summer; vaccine updates can be done at the same time, or during the second week of school.
The third page of the Student Health Record asks for personal health histories. Please complete all areas of the form. It is very important that we know about any allergies, daily medicines, and medical conditions.
When you have the form completed, you may send it to the admissions office or bring it with you on your registration day. It will be reviewed by one of our nurse practitioners and if information is missing, you will receive a letter letting you know what other information is still needed. Your student will not be allowed to register for the second semester until the record is turned in and complete.
The Student Health Center is not open for student "visits" during the summer, but will be open to receive records and answer questions. The records will then be checked by our staff and you and your student will receive a letter if information is still needed to complete the form.
© University of Indianapolis • 1400 East Hanna Avenue •
Indianapolis, Indiana 46227 • U.S.A.
(317) 788–3368 • 800–232–8634 • healthservices.uindy.edu • healthservices@uindy.edu
