Health Form Checklist

This checklist is being provided to assist you in completion of your Health Center packet. Before submitting your form, please review the items below for completion. All documents must ve in English:

  1. Complete and sign the International Student Health Form. If you are under 18 years of age a parent signature is also required on the form.

  2. Proof of immunization/immunity is attached. Acceptable documentation includes: travel documents, official school record, official health department record, medical record from health care provider’s office. Alternatively, you may have your health care provider complete the immunization section of the Health History Form. If a health care provider completes the information on the form they must also sign the form. If you are missing documentation for the required vaccinations, you may repeat the immunization or demonstrate proof of immunity with a titer (a blood test-MMR panel).

  3. Documentation of a negative IGRA blood test or a chest x-ray demonstrating that you are free of TB

You may obtain a tuberculin skin test upon arrival in the United States, however, it is strongly recommended to have all tests completed before arrival in the United States.

 

Reports MUST be in ENGLISH and certified by a physician. Immunization information and TB test/x-ray information must be official documents or include a health care provider’s signature.

 

Thank You for your attention to these details. If you have any questions, don’t hesitate to contact us at 219-464-5060 or by email at Health.Center@valpo.edu