Student Health Forms

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All new full time students attending St. Lawrence University are required to submit the following documents for their student health file so they arrive on campus no later than JANUARY 13.

General Health History Form
This form is to be completed by the student only. Incomplete forms will not be accepted. Please feel free to elaborate on any significant health issues on a separate page and attach.

Comprehensive Physical Exam Form
This form is to be completed and signed by your health care provider. A physical exam is required and must be recorded on our form and dated within 12 months of your arrival to campus. Incomplete forms cannot be accepted.

Vaccination and Tuberculosis Screening Record
Please ask your health care provider to complete this form and request that all vaccinations and TB test results are properly recorded and up to date. This form must be signed and dated by your health care provider. We will accept an attached vaccination record as long as all vaccination and PPD requirements are up to date. It must be legible and signed by a health care provider. Note: Although you may be considered low risk for TB, the date and result of a recent PPD (TB skin test) is required. The test has to be dated within 6 months of your arrival to campus. If your PPD result is positive, please attach a recent chest xray report. If previously vaccinated with BCG, you are still required to have a recent PPD administered.

Meningitis Response Form
This form must be completed by the student and returned if you have chosen not to receive the meningitis vaccination. We are required by New York State law to include this form in your student health file if you have refused the vaccine. The meningitis vaccination is not required, but is recommended for all college students living on campus.

Privacy Practices Form
Federal law prohibits the release of your medical records, if you are 18 years of age or older, to anyone without your written consent. You are required to read the Notice of Privacy information and sign the Privacy Practices form found on the last page.

You will not be able to check into your room or attend classes until these forms have been received and all health requirements have been met.

For confidentiality purposes, all health forms should be placed in and envelope and addressed directly to:

All three forms should be returned in an envelope and addressed to:
Diana B. Torrey ’82 Health and Counseling Center
St. Lawrence University
23 Romoda Drive
Canton, NY 13617

Please allow at least 10 days for the mail to reach us and be processed. For more information, call the Health Center at 315-229-5392 or visit www.stlawu.edu/health.

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