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Student Health Forms

A physical examination form and immunization history form are required for all FULL-TIME students and should be completed and returned to the student health center no later than Aug. 1 for the fall semester or Dec. 15 for the spring semester. 

Step 1:  Download the New Student Health Forms
Step 2: Use one of these two options to submit your completed forms:
    • Using the UT Online Student Health Portal: Once you have received your network (Spartans Domain) user name and password, you may use our Online Student Health Portal to upload the completed forms directly into your electronic medical record at the student health center. Go to the UT Online Student Health Portal, log in using your network (Spartans Domain) user name and password, and follow the instructions to upload documents.
    • Mail Forms: Mail forms labeled "Attention: Health Center" to the address at the top of the completed forms. Do not send forms separately. DO NOT send any other documents assigned to other departments with your health forms.

Note: We do not accept faxed or emailed forms; please use one of the two above options.


Why complete these forms?

Completion of these forms is required for all new students. These forms must be completed by the deadlines (Aug. 1 for fall and Dec. 15 for spring) in order to qualify for curbside check-in.

Who must complete the forms?

Student Physical Examination Form: Must be completed and signed by a licensed physician or nurse practitioner. Blood work and urinalysis are required, and results must be documented on the form or attached.

Student Immunization Form: Must be completed and signed by a health care provider or other signed documentation must be provided. Please be aware that failure to provide these records may prevent you from registering for classes.

Authorization to Treat a Minor Form: Must be signed by a parent or legal guardian for any student under age 18 before receiving treatment at the health center.

Which vaccinations are required and recommended?

  • The State of Florida REQUIRES proof of two measles injections or results of a measles titer proving proper antibody levels.
  • The meningitis vaccine is REQUIRED and cannot be waived for all students living in campus housing. 
  • The Hepatitis B vaccine series is highly recommended. If you refuse to have the Hepatitis B vaccines, the student or a parent (if you are under age 18) must sign the Waiver of Liability section of the Immunization History form.

Are there benefits to using the UT Online Student Health Portal over mailing forms?

Yes. Your forms are processed faster by using the UT Online Student Health Portal for submission. You can also complete your medical history questionnaire (required prior to receiving treatment at the health center) and enter the dates of the required immunizations as they are documented on your Student Immunization History Form to ensure compliance with UT’s immunization policy.

Who do I contact with additional questions?

If you have any questions about the student health center, these forms or the UT Online Student Health Portal, please call (813) 253-6250 or visit the Health and Welless Center.

If you are having problems logging into the UT Online Student Health Portal with your network (Spartans Domain) user name and password sent to you by the Admissions Office, please contact the Student Helpdesk at or at (813) 253-6255.