Student Health Forms

The forms in this section are required for all FULL-TIME students and should be completed and returned by Aug. 1 for the fall semester or Dec. 15 for the spring semester. Do not send forms separately. Please send them all marked "Attention: Health Center," a total of five pages, to the address at the top of the forms. DO NOT fax your forms. DO NOT send any other documents assigned to other departments with your health forms. Please make sure your Student ID number is on each page. If you have any questions about the Health Center or these forms, please call (813) 253-6250.

Download the New Student Health Forms  

Student Health Information

This form, appropriately completed and signed, is required prior to receiving treatment at the Health Center. You will notice a "Permission to Treat" statement on this form that must be signed by a parent for any student under age 18.

Student Physical Examination

This form must be completed and signed by a physician or nurse practitioner. Bloodwork and urinalysis are required. Documentation of immunization dates is also essential. The State of Florida requires proof of two measles injections or results of a measles titer proving proper antibody levels. Please be aware that failure to provide these records may prevent you from registering for classes.

Meningitis and Hepatitis B: Vaccine Information Form

This form must be completed and signed by a health care provider.  The Meningitis vaccine is REQUIRED and cannot be waived for ALL students living on campus.  If you refuse to have the Hepatitis B vaccine, you or a parent (if you are under age 18) must sign the Waiver of Liability section of the form. These signatures must be witnessed.