Required Medical and Health Information
On behalf of Student Health Services, I would like to take this opportunity to welcome you to Assumption College.
Assumption College requires a Medical Report Form to be on file for all students (including intercollegiate athletes) in Student Health Services no later than July 15, 2012. Failure to do so will result in the inability to move into on-campus housing or attend classes.
Here is a list of what incoming students need to do:
- Print out, complete, and return the mandatory Healthl Report Form
- Your health care provider must sign the following items that are attached to the Medical Report Form:
- Medical History & Physical Exam
- We will accept a copy of your last physical examination (within 18 months) on your own physician's form or he/she can complete our Physical Examination Form.
- Tuberculosis Risk Questionnaire (page 3)
- Immunization Record (page 4)
- Assumption College fully complies with Massachusetts State Law regarding college immunizations. According to State law, a student who is not fully immunized is excluded from classes and/or campus.
- Massachusetts State Law requires that students review the State's information about Meningococcal Disease and the vaccination.
- The vaccine for Meningococcal Meningitis is required for full-time, residential students, unless you choose to waive the requirement.
- Fax or mail the signed hard copies of the Medical Report Form, including photocopies of your health insurance card(s) to:
Student Health Services
500 Salisbury Street
Worcester, MA 01609
Fax: (508) 767-7102
Note: We recommend you maintain a copy of your medical Report Form and bring it with you to “Check-in/Move-in Day.” We will notify students in advance if any required information is missing.
If you have any questions, please do not hesitate to call Student Health Services at (508) 767-7329 or email firstname.lastname@example.org for information or assistance.
Director of Student Health Services