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Student Health Forms

A physical examination form, immunization history form and medical history questionnaire are all required for 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.

Students are required to complete all documentation electronically. We DO NOT ACCEPT forms by fax, mail or email.

Step 1: Download the New Student Health Forms

Step 2: Go to the online student health portal

Step 3: Sign-in to the 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.

Step 4: Complete the Medical History Questionnaire electronically. This is completed by clicking on forms, then look under Patient Portal and select Health Center: Medical History-Required
    »Enter immunization dates electronically under the immunization tab
    »Upload the completed Mandatory Immunization History Form under the upload tab and choose immunization documentation
    »Upload the completed Permission to Treat a Minor Child (if applicable) under, upload, then choose form Permission to Treat a Minor Child

FREQUENTLY ASKED QUESTIONS:

Why complete these forms?

Completion of these forms is required for all students. These forms must be completed by the deadlines (Aug. 1 for fall and Dec. 15 for spring). 

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. 

Medical History Questionnaire:  Completed by the student.   

Student Immunization Form: Must be completed and signed by the student's 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?

  • 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 for all students living in campus housing and cannot be waived. 
  • 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.

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 Wellness 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 studenthelp@ut.edu or at (813) 253-6255.