Health and Immunization Forms
- Health History Form (also called Student Health Form) and Immunization Record Form
To correctly fill out these forms, follow these instructions.
- Go to both links above, download and print both forms.
- Complete both pages of the Health History Form.
- Complete the Immunization Form providing the documentation of all immunization information
- Include verification of immunization information by health care provider, proof of meningitis vaccination or signed waiver, stamp, signature or official copies. See Required Immunizations and Student Liability Release and Waiver / Meningitis Vaccine
- Signatures are required: of the student and/or parent or guardian if under 18 years
- Copy of insurance card, both sides.
- Please mail in, fax or hand deliver records to Student Health Services (please do not email).
- Use this address to mail:
Student Health Services
181 Calhoun Street
Charleston, South Carolina 29424
The Health History and Immunization Forms contains valuable information including a medical history, allergies and immunizations. This information is helpful to our being able to provide our students with the best possible care. Information provided will not affect admission but must be completed before classes begin. Information is strictly for use by Student Health Services staff and will not be released without the student's knowledge and written consent.
Vaccine preventable diseases are still occurring on college campuses throughout the country. The staff at Student Health Services strongly urges students and families to give careful thought to the following recommendations. These recommendations are taken from the American College Health Association (ACHA) Vaccine Preventable Diseases Committee, Centers for Disease Control (CDC), the Advisory Committee on Immunization Practices (ACIP) and Travax, a traveler’s health service that the College subscribes to.
All vaccines listed are available at Student Health Services for a fee.
Students may call for a nurse appointment.
Call 843.953.5520, Monday - Friday, 8:30am - 5:00pm