Health Services Forms and Requirements
Making sure everyone at Adelphi stays healthy.
Immunization Requirements
Please be advised of the mandatory immunization requirements for Measles, Mumps, and Rubella and Meningococcal Disease (Meningitis) Immunizations must be met prior to the first day of classes for each semester!
Forms
- Complete Health and Immunization Forms (PDF)
(includes Health History and Assessment, MMR Immunization Requirement Form and Meningococcal Meningitis Vaccine Response Form.) - Annual Health History and Physical Form (PDF)
(Part C of the Complete Health and Immunization Forms. This form must be re-submitted annually by students in certain programs prior to beginning field work, including nursing students in clinical rotations and education students working in schools.) - Meningococcal Meningitis Vaccine Response Form (PDF)
(Part D of the Complete Health and Immunization Forms.) - Declination of Hepatitis B Vaccine Form (PDF)
- Release of Patient Health Information Form (PDF)
- Influenza Vaccination Form (PDF)
- Athletic Clearance (PDF)
Other Requirements
Insurance Information
Health Insurance is mandatory for all residential and international students.
Athletic Clearance Requirements
Every Adelphi student athlete is required to be seen by the Nurse Practitioner in Health Services for their final clearance to play collegiate sports. This appointment allows the practitioner to review the student’s health history, perform an EKG and discuss Sickle Cell testing.
Student Teaching Clearance
All students participating in student teaching must meet health clearance requirements prior to their site attendance.
Patient’s Bill of Rights and Responsibilities
As a patient at the Adelphi University Health Services Center, you have certain rights and responsibilities.