{"id":48,"date":"2020-06-03T11:24:30","date_gmt":"2020-06-03T15:24:30","guid":{"rendered":"https:\/\/www.adelphi.edu\/health\/?page_id=48"},"modified":"2026-07-31T16:57:32","modified_gmt":"2026-07-31T20:57:32","slug":"forms-and-requirements","status":"publish","type":"page","link":"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/","title":{"rendered":"Health Forms &#038; Requirements"},"content":{"rendered":"<h2>Medical Clearance<\/h2>\n<p>All students are required to complete and submit health forms and immunization documentation prior to the first day of classes for each semester. <span>Students must meet New York State immunization requirements and the<\/span><span> <\/span>Health Services Center<span> <\/span><span>standards.<\/span><\/p>\n<ol>\n<li>A completed<span> <\/span><a href=\"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/\">Health History and Assessment<\/a><span> <\/span>form.<\/li>\n<li>Completed <a href=\"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/immunization-requirements\/\">Immunization Requirements<\/a>:\n<ul>\n<li>Measles, Mumps and Rubella (MMR) Immunization Requirement Form is Part B of the <a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/06\/Complete-Health-and-Immunization-Forms.pdf\">Complete Health and Immunization Forms<\/a>.<\/li>\n<li>Meningococcal Vaccination Response Form is Part D of the <a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/06\/Complete-Health-and-Immunization-Forms.pdf\">Complete Health and Immunization Forms<\/a>.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<h3>How To Submit Your Documents<\/h3>\n<ul>\n<li><strong>Email: <\/strong><a href=\"mailto:healthservicescenter@adelphi.edu\">healthservicescenter@adelphi.edu<\/a><\/li>\n<li><strong>Fax:<\/strong> 516.877.6008<\/li>\n<li><strong>Mail: <\/strong>Send copies of your records to the following address:<strong><br \/>\n<\/strong><br \/>\n糖心破解版 Health Services Center<br \/>\nWaldo Hall<br \/>\n1 South Avenue<br \/>\nGarden City, NY 11530<\/li>\n<\/ul>\n<h3><span>Athletic Clearance Requirements<\/span><\/h3>\n<p><span>Every 糖心破解版 student-athlete is required to be seen by the Nurse Practitioner in Health Services for their <a href=\"https:\/\/www.adelphi.edu\/policies\/athletic-clearance-requirements\/\">final clearance to play collegiate sports<\/a>. This appointment allows the practitioner to review the student\u2019s health history, perform an EKG and discuss Sickle Cell testing.<\/span><\/p>\n<h3>Student Teaching Medical Clearance<\/h3>\n<p>All 糖心破解版 students participating in <a href=\"https:\/\/intranet.adelphi.edu\/education\/student-teaching-practicums\/applying-for-student-teaching\/\">student teaching<\/a> must meet health clearance requirements prior to their on-site attendance.<\/p>\n<h2>Health Forms<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2023\/04\/Complete-Health-and-Immunization-Forms_April-18-2023.pdf\" target=\"_blank\" rel=\"noopener\">Complete Health and Immunization Forms<\/a> (PDF)<br \/>\n(includes Health History and Assessment, MMR Immunization Requirement Form and Meningococcal Meningitis Vaccine Response Form.)<\/li>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/06\/Health-Clearance-Form.pdf\" target=\"_blank\" rel=\"noopener\">Annual Health History and Physical Form<\/a> (PDF)<br \/>\n(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.)<\/li>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/06\/Declination-of-Hepatitis-B-Vaccine.pdf\" target=\"_blank\" rel=\"noopener\">Declination of Hepatitis B Vaccine Form<\/a> (PDF)<\/li>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/06\/Release-of-Patient-Health-Information.pdf\" target=\"_blank\" rel=\"noopener\">Release of Patient Health Information Form<\/a> (PDF)<\/li>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2026\/07\/Influenza-Vaccination-Form_rev2026.pdf\" target=\"_blank\" rel=\"noopener\">Influenza Vaccination Form<\/a> (PDF)<\/li>\n<li><a href=\"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2020\/07\/Athletic-Pre-Assess-2020.pdf\" target=\"_blank\" rel=\"noopener\">Athletic Clearance<\/a> (PDF)<\/li>\n<\/ul>\n<h2>Patient\u2019s Bill of Rights<\/h2>\n<p>As a patient at the 糖心破解版 Health Services Center, you have certain <a href=\"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/patients-bill-of-rights\/\">rights and responsibilities<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medical Clearance All students are required to complete and submit health forms and immunization documentation prior to the first day of classes for each semester. Students must meet New York State immunization requirements and the Health Services Center standards. A completed Health History and Assessment form. Completed Immunization Requirements: Measles, Mumps and Rubella (MMR) Immunization&hellip;<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":0,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-48","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<title>Health Health Forms &amp; Requirements | Immunizations &amp; Health Insurance<\/title>\n<meta name=\"description\" content=\"Find the forms and requirements needed before you come to 糖心破解版&#039;s campus. 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These forms are important to the Health Services Center.","og_url":"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/","og_site_name":"Health Services","article_modified_time":"2026-07-31T20:57:32+00:00","og_image":[{"width":1024,"height":681,"url":"https:\/\/www.adelphi.edu\/health\/wp-content\/uploads\/sites\/30\/2022\/10\/Health-Services-58-1024x681.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/","url":"https:\/\/www.adelphi.edu\/health\/forms-and-requirements\/","name":"Health Health Forms & Requirements | Immunizations & Health Insurance","isPartOf":{"@id":"https:\/\/www.adelphi.edu\/health\/#website"},"datePublished":"2020-06-03T15:24:30+00:00","dateModified":"2026-07-31T20:57:32+00:00","description":"Find the forms and requirements needed before you come to 糖心破解版's campus. 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