The Physical Form is not mandatory but it is strongly recommended for students who are planning to use the services offered at the Student Health Service. If you are unable to submit a completed copy of the Physical Form, submit a copy of your immunization records and a copy of your most recent physical done at your doctor's. If you would like more information as to what immunization information is required from you, please click the following link Immunization Requirements. If you are a Varsity Athlete and you want to know what must be submitted for Athletic Clearance, please click the following link Athletic Clearance.
Submit all documents via the Student Health Service Portal hosted by Medicat https://newpaltz.medicatconnect.com
Immunization Records (Required prior to the start of classes)
Health Report (Recommended)
Questions?? Call Student Health Service 845-257-3400
**Immunizations/Physical should be submitted 1 month prior to classes to allow for processing**
**NEW STUDENT/FRESHMAN HEALTH PAPERWORK** (we will accept physicals up to 2 years old for non-athletes)
**Please download these forms to your desktop and complete them in Adobe. If you complete the forms in a web browser, they will not save properly. If completing the forms in Adobe is not possible, please print out the forms, complete them by hand and scan them to your Medicat Portal. There are many free scanner apps for smart phones you can utilize. You can also try completing the forms on your smart phone or tablet and submit them through the Student Health Service Portal hosted by Medicat.
Physical Form - If your provider does not wish to complete this form, you may attach copies of your immunization records and your most recent physical (we accept physicals up to 2 years old).
ISOLATION AFFIRMATION FORMS
Pre-Appointment Forms:
The following forms are only to be completed if asked to do so by a Triage Nurse for an appointment at SHS.
**Please download these forms to your desktop and complete them in Adobe. If you complete the forms in a web browser, they will not save properly. If completing the forms in Adobe is not possible, please print out the forms, complete them by hand and scan them to your Medicat Portal. There are many free scanner apps for smart phones you can utilize. You can also try completing the forms on your smart phone or tablet and submit them through the Student Health Service Portal hosted by Medicat.
Overseas Academic Programs Form
Additional Forms:
The following forms are only to be completed if you choose not to complete the Physical Form:
**Please download these forms to your desktop and complete them in Adobe. If you complete the forms in a web browser, they will not save properly. If completing the forms in Adobe is not possible, please print out the forms, complete them by hand and scan them to your Medicat Portal. There are many free scanner apps for smart phones you can utilize. You can also try completing the forms on your smart phone or tablet and submit them through the Student Health Service Portal hosted by Medicat.
Demographics - Included in the Physical
Health History - Included in the Physical
Meningococcal Disease Fact Sheet
Meningitis Vaccination Response Form - Meningitis ACWY Vaccine must be given within 5 years of the start of classes. If your Meningitis Vaccine was given more than 5 years ago, please check the bottom box on this form in order to fulfill the requirement.
available on Student Health Service Portal hosted by Medicat
Minor Consent Form - Required only for students under the age of 18 years old, available on Student Health Service Portal hosted by Medicat
Tuberculosis Screening Questionnaire - available on Student Health Service Portal hosted by Medicat
Additional Forms:
Allergy Questionnaire - Required only for students with allergies to foods/stinging insects.
Asthma Questionnaire - Required only for students with a history of Asthma.
Immunization Records Request Form - For more info., please click the following link: Records Request
Leave of Absence Form - For more info., please click the following link: Leave of Absence.
Release of Records From Student Health Service Records Request
Release of Records To Student Health Service
Exemption Forms forms for MMR Requirements ONLY:
Medical Exemption Form for MMR Vaccinations
Religious Exemption Form for MMR Vaccinations
