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All new students must complete a health form as part of their admission requirements.
You may also download and print additional copies of the health form.

A completed health form contains:

• Personal demographic information: name, address, phone, emergency contacts
• Proof of completed required immunizations: For a fee, to cover the cost of the vaccine, the Student Health Center can administer these vaccines to students who don't have updated and completed immunizations.
• An explanation of required immunizations can be found on the health form
• A completed health history

If any of this information is incomplete, you will receive notification (written and/or via e-mail) informing you of any deficiencies regarding your Health Center requirements. A hold will be placed on your records, which will not be lifted until all requirements are completed. Call (570) 389-4451 for more information.

If you are registered for nine or more credits, you must complete the three page health form and return it to the Student Health Center prior to your first semester as outlined below:

• April 1 for Summer Admission
• July 1 for Fall Admission
• Dec. 1 for Spring Admission

The health form consists of three pages, which must be completed and returned to the Student Health Center.
This can be done in the following ways:

• Print out the three pages of the health form, complete and send to the health center via regular mail service. The address is found on the cover page of the health form.
• Print out the three pages of the health form, complete and fax to the health center at (570) 389-3417.

Please note: All immunization information must be complete. Places where you can find out immunization information:

• Your family doctor
• Your baby book with your shot records
• Your high school
• Military records

If you cannot find any information concerning your immunizations, you may opt to have blood titers drawn by your physician to determine your immunity to measles (rubeola—illness which lasts approximately two weeks or more), mumps, rubella (known as the 3 day measles), varicella (known as chickenpox) and hepatitis B.

If you are deficient in any required immunizations and you are interested in receiving those immunizations at the Student Health Center, upon your arrival, please contact us at (570)-389-4451.

You may also call your local Department of Health (DOH) and inquire if you are eligible for any free immunizations or if you could receive any pay for your immunizations at the DOH.

International Students

You will have additional requirements. All health and insurance information MUST be submitted in English. Health insurance is a requirement for all international students as directed by the United States Citizenship and Immigration Services (formerly the INS). Please contact the Bloomsburg University International Office at (570) 389-4199 if you have questions.

Nursing Students

Freshman students, majoring in nursing, will complete the same requirements as all other new BU freshmen students. Beginning the sophomore year, when nursing students begin their clinical rotations, nursing students will have additional health requirements.

A yearly physical exam and yearly tuberculin skin test will be required. The physical exam must be done by a health care provider (doctor, nurse practitioner or physician’s assistant). THE PHYSICAL MUST BE COMPLETED IN ITS ENTIRETY AND RETURNED ON TIME to avoid a hold being placed on records and delays in scheduling and registering.

The physical form can be obtained from the Nursing Department or can be downloaded and printed here:

Undergraduate Form | Graduate Form

Completed physical exam forms are to be submitted to the Student Health Center. If you have any questions, please contact the Nursing Department at (570) 389-4423.

All Students

Please read the meningitis information located on page two of the health form. For our records, all students must decide whether or not they want to receive the vaccine. If you decide that you do not want the vaccine, you must sign the waiver found at the bottom of page two.

Accident and Sickness health insurance coverage is recommended for all students. The Student Health Center fee covers only the basic medical care given at the Student Health Center. If health insurance is not carried, the University will not be held responsible for costs of health care received at other medical facilities such as: diagnostic testing, hospitalization, emergency room visits, medications, etc. These costs will be the responsibility of the student.