Health Center

Forms

   a photo of forms

**Please note, if you are a returning student and you have already submitted your health records the previous year/semester, then you do not need to resubmit any information. The information you submit as a Freshman/Transfer student will cover you through graduation.** 

The Health Report 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 print the Health Report and bring it to your doctor, please have your doctor fax your immunization records to us along with a copy of your most recent physical. 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

All paperwork can be submitted to our office via the following methods:

FAX: 845-257-3415
EMAIL: healthservice@newpaltz.edu
MAIL: Student Health Service, SUNY New Paltz, 1 Hawk Drive, New Paltz, NY 12561

Please only submit your records one time. The Student Health Service does not need any original copies. We encourage anybody mailing original copies of any documents to keep a second copy safe at home.

**Health Reports/Immunizations are due 1 month prior to the start of classes** 

**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 back to us. 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 emailing them back to us.

Health Report - The Health Report includes the Health History, Demographics, TB Screening Questionnaire, Minor Consent and Meningitis Vaccination Response Form all inside the 6 page packet. The individual Health History, Demographics, TB Screening Questionnaire, Minor Consent and Meningitis forms (below) are required for students who are only submitting immunization records and not completing the full Health Report.

Health History

Demographics

TB Screening Questionnaire

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.

Minor Consent - Required only for students under the age of 18 years old.

 

Pre-Appointment Forms:

**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 back to us. 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 emailing them back to us.

ECP Form

Injury Report

MMR Vaccination Screening Questionnaire

Overseas Academic Programs Form

Sexual Health History Form

TST Administration Form

Urine Screening Form

 

Additional Forms:

**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 back to us. 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 emailing them back to us.

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.   

Medical Exemption Form for Vaccinations 

Meningococcal Disease Fact Sheet

Release of Records From Student Health Service - For more info., please click the following link: Records Request

Release of Records To Student Health Service - For more info., please click the following link: Records Request

Religious Exemption for Vaccinations - This form must be completed and signed by the student if they are 18 years or older and it must be notarized.

Student Immunization Form