Health Services
Division of Student Life

Health History

The Health History is a 3-page self-reported form that you complete yourself; you don't need to have a doctor's physical to complete it. You can get your immunization dates from your physician, previous school, or your personal health records.  Please note the "Required Immunizations" are as follows:

• Tetanus (Td, Tdap) within 10 years of admission to SRU
• Measles, Mumps, Rubella (MMR)-two different doses/dates required
• Meningitis-if you are residing in campus housing. You will need to provide proof of vaccination (signature of health care provider or stamped immunization record)or sign a waiver.

Immunization vaccines are available ,for an additional fee, at the Student Health Center when students are actively enrolled in classes.

Carefully complete the Health History and return it to the Health Center as soon as possible.  It will be included in your health record and kept confidential.  If you have any questions, please call us at 724-738-2052.

Click here to download the Health History form in Microsoft Word.