Forms and Exemptions

All new students should submit an Immunization Form before the start of classes.   

If you would like the Health Office to release your immunization records to another school, please submit the Health Office Release of Information Authorization.

Vaccine Exemptions

Religious Exemption:  Students who hold genuine religious beliefs against being immunized against measles, mumps, and rubella will be exempt from PHL 2165 after submitting a request that has been approved by the college. To request an exemption the Religious Exemption Request Form must be submitted to the Health Office.  Please read the instructions on the form carefully before submitting your request.  In the event of a measles, mumps, or rubella outbreak, students may be excluded from classes or campus.  

Medical Exemption:  If a licensed physician or nurse practitioner, or licensed midwife caring for a pregnant student certifies in writing that the student has a health condition which is a valid contraindication to receiving a specific vaccine, then a permanent or temporary exemption may be granted. This statement must specify those immunizations which may be detrimental and the length of time they may be detrimental.  In the event of an outbreak, medically exempt individuals should be protected from exposure. This may include exclusion from classes or campus.  To apply please submit a  Medical Exemption Request Form  to the Health Office.