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Health History Form FAQs

Q#1: I started filling out my form in ink. Is that ok? While we prefer you to use a pencil for the entire form, it is ok to use blue or black ink. If you have not finished the form, please switch to pencil to finish the rest of the form. You do not need to request a new form.

Q#2: What immunizations are required? Students must meet the New York State and University of Rochester immunization requirements. For the full list of mandatory immunizations, check Immunization Requirements for Full-time Students.

The mandatory immunizations are as follows:

  • 2 doses of live measles vaccine*
  • 1 dose of mumps vaccine*
  • 1 dose of rubella vaccine*
  • 1 dose of meningococcal vaccine or signed declination
  • PPD (tuberculosis skin test) for students from specific countries. See Q#3 below.
  • 1 TD or Tdap (Tetanus), and
  • 1 Polio (date of completion).

* Note: MMR (measles, mumps & rubella) vaccine may be used to satisfy a single dose of measles, mumps and rubella.

Q#3: Do I have to do a PPD (tuberculin skin test)?  What should I do if I have a positive PPD Test? Students who have lived in a Country that is endemic for Tuberculosis within the last 5 years for a period of more than 3 months at a time (See List of Countries with Low Incidence of Tuberculosis.) or Health Professional Students must take the PPD test. Your test must be within 6 months of the start of your classes. PPD tests completed more than 6 months before admission date are invalid. You do not need a chest x-ray if your PPD result is negative (less than 10 mm). If you have a PPD test that is positive (10mm or over induration) then you must have a chest x-ray done.  Please only provide the chest x-ray report. Do not provide the actual x-ray film or a CD of the results. We must have a printed paper report. On the Health History Form, please write the words (QFT-G) in the PPD box area and make sure you include the paperwork.

Q#4: I cannot get a PPD test because it is not offered where I am from.  If you cannot get the PPD test (because it is not available in your area) before you come to school, there is another option. It’s called QuantiFERON ®-TB Gold (QFT-G). This is a new FDA approved blood test (titer) for the detection of tuberculosis (TB) infection. QFT-G is highly specific and a positive test result is strongly predictive of true infection of Tuberculosis.   Since this is a blood draw (titer), a copy of the laboratory results must accompany your paperwork. If you do have a Positive test result with a QFT-G test, you must treat it the same as a PPD test and you must have a chest x-ray done. Please only provide the chest x-ray report. Do not provide the actual x-ray film or a CD of the results. We must have a printed paper report.

 Q#5: Does my doctor need to sign my Health History Form? My doctor is no longer in practice. Where can I get my immunization records? We must have official documentation of your immunizations; however, this does not always mean that your doctor must sign the form. If you have official immunization documentation from your school or from your healthcare provider’s office, we can accept that documentation in place of a physician’s signature on your Health History Form. You will still need to fill out the ovals in the immunization section of the University of Rochester’s Health History Form. You will still need to fill out the ovals in the immunization section of the University of Rochester’s Health History Form. The official immunization documentation from your past school or healthcare provider serves as the physician’s signature, showing proof of the dates that you entered onto the form.

Q#6: Can I turn in my form late? I cannot schedule an appointment with my doctor until after the due date.  Our goal is to receive the majority of forms from incoming students by June 30 for the fall semester (December 31 for the students beginning in January). We realize some students will be unable to meet this timeframe for a variety of reasons. Please send your form as soon as you can, but with the intention of the form getting to us before you arrive in Rochester. If your Health History Form is not ready by the due date, do not send in any other paperwork now and the Health History Form later. To assure proper input of your information, please send in all of your paperwork including the Health History Form at the same time.

If you are a full-time student and you have the red bubble form, you cannot email a scanned copy or fax your form to our office. Please send the original form via regular mail. Since the form is a Scan-a-tron form, we can only accept the printed original form. Overnight mail is not needed unless you think your form will not reach us by regular mail before you arrive in Rochester. If you must use overnight mail, the substitute address for the PO Box 270617 is 738 Library Road. The rest of the address is the same.

Q#7: If I cannot get my immunizations completed before I come to school, what should I do?

While it is important that you receive the immunizations before you come to Rochester, you can receive any immunization, if you do not have them yet in order to be compliant, at the University Health Service (UHS) after you come to campus. Call 585-275-2662 to schedule an appointment. Please let the receptionist know you would like to complete your immunization requirement. If you have chosen the UR Student Health Insurance Plan (Aetna) from the University, you may not have to pay for the immunization shot. Otherwise, there will be a charge for the office visit and the immunizations since completing your immunizations is a pre-enrollment requirement. We will charge the cost to your tuition billing statement unless you prefer to pay by check or credit card.

We suggest that you mail your Health History form in now so that it arrives before you arrive in Rochester.  We will enter your information into our system upon receipt of your form. Then, as soon as you arrive in Rochester, please call UHS at 585-275-2662 to schedule your appointment for your missing vaccination(s).

When mailing your Health History Form to the University Health Service, you should not need to use an overnight mail service unless you think your form will not reach us by regular mail before you arrive in Rochester. If you must use overnight mail, the substitute address for the PO Box 270617 is 738 Library Road. The rest of the address is the same.

Q#8: Do I need to fill out all the ovals (bubbles) on the Health History Form? Why is there a charge for $25 on the form? Yes, you need to fill in the ovals (bubbles) that match the dates of immunizations on the official immunization record. Please darken the circle completely using a pencil (or blue or black ink pen, if you do not have a pencil). Do not put a check mark or X in the circle. The $25 fee is only for students who do not fully fill in the ovals (bubbles) on the form. Please be sure to sign and date the form where indicated in Part 5. The form cannot be processed without your signature and date.

Q#9: Can I send a copy of my official immunization record or do I need to send the original?  You can send a copy of your immunization record. We recommend keeping the original for your own records. Please be sure you fill in the ovals (bubbles) on the University of Rochester Health History Form that match the dates of immunizations on the official immunization record. The official immunization documentation from your past school or healthcare provider will serve as the physician’s signature, showing proof of the dates that you put on our form.

Q#10: How do I know if you received my Health History Form or if anything is missing? Due to the large number of forms received, we do not send a confirmation to let you know your form has been received. We will notify students whose forms are incomplete or have not been received within 30-45 days after the beginning of classes. If you do not receive a letter from UHS, you can assume your form was received and is complete. Please always check your spam email, just in case. Our suggestion to you is to bring ALL of your immunization records with you when you come to the University of Rochester. Then if your form does not reach us and you need to fill out another one, you can come to Room 203 in the UHS Building and fill out the Health History Form, using your immunization records that you brought with you from home.

Q#11: Can I send a scanned email copy or fax of my form? If you are a full-time student, you must submit the original form. You cannot email or fax your form to our office. Since the form is optically scanned, we can only accept the printed original red bubble form.

Even though June 30 is the deadline, we realize some students will be unable to meet this timeframe for a variety of reasons. If you cannot meet the deadline, please send your form as soon as you can, so that it arrives before you arrive in Rochester. You should not need to use an overnight mail service unless you think your form will not reach us by regular mail before you arrive in Rochester. If you must use overnight mail, the substitute address for the PO Box 270617 is 738 Library Rd. The rest of the address is the same.

Q#12: My doctor is no longer in practice. Where can I get my immunization records? You can check with your high school or elementary school to see if they have your immunization record. We can accept the signature of an authorized school official. If you attended another college or university before coming to the University of Rochester, you could ask to have your immunization record sent to you, so you can fill out the University Health History Form. Please mail everything to us together.

Q#13: Do I need to have a physical to complete the Health History Form? A physical is not required to complete the Health History Form; however, we realize some doctor’s’ offices may require a student have a physical before they will complete the form. If your doctor requires you to have a physical, you may find you cannot schedule one before June 30. If that is the case, you can send in your form as soon as you can with the intention of getting it to us before you arrive in Rochester. Since the form is a Scan-a-tron form, we can only accept the printed original form. Please do not email a scanned copy or fax your form to our office. You must send the original form via regular mail.

Q#14: I am a current UR employee, what do I need to do? Even though you are a current UR employee, being an employee and a student are looked at separately in the eyes of New York State laws for immunization verification. The University’s office of Occupational Environmental Medicine (OEM) deals with employee medical records while the University Health Service (UHS) deals with medical records for students. Due to HIPAA regulations, OEM and UHS are not allowed to cross reference medical information. The employee must request their records themselves. Please call OEM at 585-487-1000 to request your immunization information. You may need to go to the OEM office to pick up your immunization record. Please do not ask OEM to mail your record to UHS.

Please fill out the Health History Form, using the OEM paperwork. When filling our form, please enter the immunization information onto our form, filling in the bubbles to correspond with the dates on the OEM paperwork. Include a copy of the OEM paperwork with the Health History Form as proof when you send the form to UHS. This way you will not need to have a doctor sign our form. If you do not fill in the bubbles on the form, you may be charged a fee.

Q#15: I misplaced my Health History Form. Can you fax a new copy to me? If you are a full-time student, we cannot fax or email the form, as you must submit an original form. Since the form is a scannable form, we can only accept the original printed form. We can send you a new form. Write to hhf@uhs.rochester.edu to request a new form. Please include your mailing address in your e-mail message.

If you are a part-time student, medical student, health profession student, or visiting medical student, you will find the form you need to complete on the UHS web site if you return to the page titled “Health Requirements for Entering Students” and scroll down to “Part Time Students” or “Medical, Nursing or Other Health Professional Students” to find your category. Click on the category that applies to you to find the form.

IF YOU HAVE AN INTERNATIONAL ADDRESS, we cannot send you the form in time. Our suggestion to you is to bring ALL of your immunization records that you can get with you when you come to the University of Rochester. Soon after arriving on campus, come to Room 203 on the second floor of the UHS Building on the River Campus. You will be able to fill out the Health history Form at UHS, using your immunization records from home.

Q#16: Can I get my form online? If you are a full-time student, you will need the full time Health History Form, which is a red bubble form. This form is NOT available online or on the UHS website since you must use the original printed copy of the form. We cannot accept a scanned or faxed copy of the form. We are sorry for this inconvenience, but the form goes through a scanning process and thus it must be the original for it to do that. If you are a full-time student, you should have received the Health History Form from your Admissions Office. If you did not receive the Health History Form by mail, contact the UHS Health History Form Office at hhf@uhs.rochester.edu.

 

Q#17: Where is the University Health Service located at on campus? When is the office open? The Health History Form Office is located in the UHS Building on the University of Rochester River Campus. (Please note: We are not located in the UR Medical Center of in Strong Memorial Hospital.) If you know the location of Rush Rees Library, you should have no problem finding the UHS Building. Our building is located directly across the Library Parking Lot. If you are standing where the buses pick up and drop off at the back of the Library, you will see our building directly across the parking lot. The Health History Form (HHF) Office is located in Room 203 on the second floor of the UHS Building. The HHF Office is open from 8am – 5pm, Monday-Friday. During the summer months (June-August), the office closes at 4pm on Fridays. We recommend avoiding coming between 11:30am – 1:30 pm due to staff lunch breaks.

Q#18: Can I turn in the Health History forms when I arrive? We apologize, but you cannot bring the form with you.  It would be best to send in all of your paperwork including the health history form all together, as close to the June 30th deadline as possible, to assure proper input of your information with the intention of getting it to us before you arrive in Rochester.

If you are a full-time student and you have the red bubble form, we cannot accept a scanned copy or faxed copy of your form. You must send the original form by mail. Since the form is a Scan-a-tron form, we can only accept the printed original form. We are sorry for this inconvenience, but the form goes through a scanning process. We need the original printed form to complete this scanning process.

We realize some students will be unable to meet this timeframe for a variety of reasons. Please send your form as soon as you can with the intention of the form being received at UHS before you arrive in Rochester. If your Health History Form is not ready by the due date, do not send in any other paperwork now and the Health History Form later. Send everything together. Overnight mail is not needed unless you think your form will not reach us by regular mail before you arrive in Rochester. If you must use overnight mail, the If you must use overnight mail, the substitute address for the PO Box 270617 is 738 Library Road. The rest of the address is the same.

Q#19: What does “Lab report for Titers” mean? A “Titer” is a blood draw from a lab to identify the amount of antibodies in a person’s blood. If you have received titers for Measles, Mumps, Rubella, or Varicella, a lab report showing positive or negative antibodies in your blood for the titers, (which is stated on the form) must be included. We cannot say that you are compliant for the MMR or Varicella titers until we have the lab report that says you had a positive reading. If you have not included the lab report with the Health History Form, please fax the lab report to 585-756-0263 or scan and email the lab report to hhf@uhs.rochester.edu.

Q#20: Do I have to do a PPD (tuberculin skin test)?  What should I do if I have a positive PPD Test?  Students who have lived in a Country that is endemic for Tuberculosis within the last 5 years for a period of more than 3 months at a time or Health Professional Students must take the PPD test. Your test must be within 6 months of the start of your classes. PPD tests completed more than 6 months before admission date are invalid.  You do not need a chest x-ray if your PPD result is negative (less than 10 mm).  You cannot substitute the PPD test with a chest x-ray.  If you have a PPD test that is positive (10mm or over induration) then you must have a chest x-ray done Please only provide the chest x-ray report.  Do not provide the actual x-ray film or a CD of the results.  We must have a printed paper report.

Q#21: Does UHS offer the HPV vaccine? UHS offers the HPV vaccine, which is recommended for students under age 26. To receive the vaccine at UHS, call 585-275-2662 to schedule an appointment. If you started the vaccine series before coming to the University, you can receive dose two and/or three at UHS. If you enroll in the UR Student Health Insurance Plan (Aetna), the plan will cover the cost of the vaccine beginning August 1. If you have another health insurance plan, we recommend you check with your insurance company to see if the HPV vaccine is covered and, if it is, if it will be covered in Rochester. Some plans do not cover the vaccine out-of-area. The University Health Service will be holding an HPV Vaccine Clinic at the beginning of the fall semester for students who would like to receive the vaccine at UHS. This clinic will be by appointment. Please call UHS after the beginning of August to schedule an appointment.

 

Q#21: Is the Meningococcal vaccine required? No, this vaccine is not required at this time. The vaccine is strongly recommended for first year undergraduate students and any other students who will be living in a residence hall. Your Health History Form packet included an information sheet about Meningococcal meningitis. The information sheet is available in the Full-time Student section of the “Health Requirements for Entering Students” page on this web site.

Q#22: Do I have to get Recommended (Page 4) Immunizations? The vaccines on the recommended page (page 4) are not mandatory. Therefore, you do not have to have the immunization(s) on page 4 of the Health History Form (HHF) to be able to attend classes at the University of Rochester. The vaccines are recommended because we believe they are important to protect from disease. The decision to get the vaccines on page 4 is your choice.

Please note that all of the vaccines listed on page 3 (6A) of the Health History Form are mandatory. You must comply with those immunizations.

You can receive any immunization, which you do not have yet in order to be compliant, at the University Health Service (UHS) after you come to campus. Call 585-275-2662 to schedule an appointment. Please let the receptionist know you would like to complete your immunization requirement. If you have chosen the UR Student Health Insurance Plan (Aetna) from the University, the immunizations may be covered by the plan. Otherwise, there will be a charge for the office visit and the immunizations since completing your immunizations is a pre-enrollment requirement. We will charge the cost to your tuition billing statement unless you prefer to pay by check or credit card.