Required Health and Immunization Forms
Forms required to maintain enrollment:
- Immunization Form (PDF): Proof of immunization to Measles-Mumps-Rubella (MMR)
- Meningitis Form (PDF): Proof of vaccination or waiver stating you understand the risks of not being vaccinated
Health form required from all students:
- Medical History and Examination Form (PDF): Required by the University for all new students
Important Notice: Per New York State Public Health Laws 2165 and 2167, you will be dropped from your courses and your University enrollment canceled if you do not submit these required forms by the deadlines.
Submit your completed health forms by mail or fax or deliver in person directly to the Queens Campus Health Center:
Queens Campus Health Center
DaSilva Hall, Room 101
Mon. to Thur., 8:30 a.m. to 5 p.m.
Fri., 8:30 a.m. to 3 p.m
Please include your name and X-number on each page of each form. Please remember to make copies of your forms for your own records. If you would like us to make a copy at a future date, we can do so for a small fee.
Frequently Asked Questions
Can I fax the forms?
Yes. You or your doctor can fax us directly. Please be sure your name and X-number appear on each page of each form.
How can I confirm your office received my forms?
You can call us after you fax it; however, we do ask for your patience due to the high volume of calls.