New Student Health and Immunization Requirements

Contact Us

Please submit all forms to the Counseling Center:

Fax: 617-879-2415

Mailing Address:
200 Riverway
Boston, MA 02215
Attn: Counseling Center

Questions?
Call us at 617-879-2410 or 617-879-2032

These web pages will outline the immunization records and other health information required of entering undergraduate and graduate students. This information is designed to facilitate a healthy and positive college experience.

Please note that these forms must be downloaded, completed, and submitted via fax or mail. If you do not have access to a computer to download the forms, please call us at 617-879-2410. All forms in the Mandatory section must be completed in their entirety before students can attend classes, participate in programs, or move into residence halls.

If you attended Wheelock as an undergraduate and are now entering as a Wheelock graduate student, you are required to submit new health forms to ensure that we have your most current information on file.

We recommend that you keep a copy of your completed forms for your records.

Note: All undergraduate students enrolled in nine or more credits and all graduate students enrolled in 7 or more credits must demonstrate that they have health insurance. See the Student Accounts/Health Insurance web page for more information about this requirement.

Mandatory Forms - Due by August 1st, 2017

These forms must be filled out by you and faxed to the Counseling Center:

  1. Entrance Health Certificate (fillable pdf) - NOTE: This is a fillable PDF that is most compatible with Google Chrome and Mozilla Firefox web browsers. Please be sure to download this form to your computer PRIOR to filling it out, or your information may be lost.
    • Personal Information
    • Emergency Contact Information
    • Health Insurance Verification
    • Permission for Medical and Emergency Treatment
  2. Meningococcal Disease and Vaccination Waiver (pdf) - Please see the Meningococcal Disease and Vaccination web page before choosing to sign this waiver.
  3. Tuberculosis Risk Questionnaire (pdf) - To be completed by you and reviewed and signed by your health care provider.

The following form must be completed and signed by your health care provider and faxed to the Counseling Center

4. Immunization Record (pdf)

*The Health and Immunization Requirement is only fulfilled once ALL 4 forms are submitted*

Optional Forms

For convenience, please submit your documents using this fax coversheet.

*Please fax completed forms back to the Counseling Center at 617-879-2415*

Requests for Copies of Immunization Records

To request a copy of your immunization record, please fill out a Health Form Request, and submit it to the Counseling Center either via fax, mail or in person. Please be ready to present your student ID when you go to retrieve your copy.

*We require 3-5 business days to fulfill your request.*

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200 Riverway, Boston, Massachusetts 02215
Contact Us | 617-879-2000

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