Health Forms

 Required Health Forms   

Dean College Health Form

The Dean College Health Form must be completed by the student or, when indicated, by the parent/guardian.  This form includes student demographics, contact information, insurance information and authorization and consent for treatment at Dean College Health Services and its affiliate providers.  The health form packet also includes a certificate of immunization, physical exam form, tuberculosis screening questionnaire and a meningitis waiver form.

If a student has appropriate health insurance coverage, the information should be noted on this form.  A copy of the student's insurance card, both sides is also requested.  All students are automatically enrolled in and charged for the Dean College Student Health Plan unless proof of comparable coverage is provided AND an on-line waiver form is completed.  More information regarding health insurance requirements can be found on our Health Insurance page.

Certificate of Immunization

Massachusetts State Law requires that all new incoming students, both new and transfer students in undergraduate and graduate programs, provide a “certificate of immunization” to the college.  This certificate should demonstrate compliance with the immunizations required by state law.  These immunizations include:

     Hepatitis B - 3 doses

     Measles, Mumps, Rubella (MMR)   - 2 doses

     Tdap (Tetanus) in last 10 years

     Meningitis vaccine within the last 5 years

     Varicella - 2 doses or medical documentation of disease

     PPD for high-risk and international students

The Dean College Certificate of Immunization form must be completed by the student’s medical provider and returned to the Health Services office prior to the start of classes.    If a student's immunization record is not updated or has been lost, then appropriate blood work to determine immunity can be done by the student’s medical provider.  The Certificate of Immunization form explains the immunizations and blood titers in detail.

Tuberculosis

Tuberculosis screening is required of all high-risk and international students attending Dean College. To accomplish this, ALL students must complete the Tuberculosis Risk Questionnaire.  If, after completing the questionnaire, the student is found to be high-risk, then PPD testing is required and the PPD section of the immunization form must be completed.  This form should accompany the Certificate of Immunization form when given to the medical provider for completion.  Both forms should be returned together to Health Services prior to the start of classes. 

Physical Exam

A physical exam is required of all new and transfer students admitted to Dean College.  The Dean College Physical Examination Form must be completed by the student’s medical provider and returned to Health Services prior to arrival on campus.  The physical exam must be within the last 12 months of starting classes at Dean College.  Athletes are required to have an annual sports physical exam and will be unable to participated in any sport without proper documentation.  The sports physical must state that they are able to participate in all athletic activities connected to that sport.