Health Requirements & Forms

Health Services Patient Portal

Please submit all documentation through the Student Health Portal. For electronic medical record security, we are unable to accept forms by fax or email. Due to the ongoing COVID-19 situation, we are also unable to accept forms in person or by mail.

Per Massachusetts regulations, as a condition of enrollment at the university and subsequently, treatment at Health Services, all full-time students, and part-time Health majors are required to have their health forms on file. 

Information about applying for a COVID-19 vaccination exemption can be obtained by calling 978-934-6800 or by emailing wellness_center.uml.edu.

Online Health Record

All newly enrolled full-time students should complete the health forms online and upload supporting medical documentation through the Health Services Patient Portal link above.

• Health History (pdf) - Students must complete both parts of the Health History Form.
• Tuberculosis Risk Assessment Questionnaire (pdf) - View list of TB-Endemic countries and answer questions.
• Immunizations (pdf) - Enter dates for required immunizations online and upload supporting medical documentation signed by Medical Provider.
  • Two doses MMR (Measles, Mumps, Rubella) vaccine or a positive blood titer test
  • Two doses of Varicella vaccine for Chicken Pox or documented history of disease, or positive blood titer
  • Three doses Hepatitis B or positive blood titer
  • One dose of Tdap vaccine within 10 years. If older than 10 years, you must also have a documented Td given within 10 years. Note: Massachusetts regulations require all full-time students have a current tetanus immunization throughout their enrollment.
  • Meningococcal vaccine - All newly enrolled full-time students 21 years of age or younger must receive one of the Meningococcal vaccines; or, sign the Department of Public Health's Meningococcal Disease and Vaccination Waiver Form.
  • COVID-19 vaccine – fully vaccinated with a U.S. Food and Drug Administration or World Health Organization authorized vaccine.
• Physical Examination Form (pdf) - Download the Physical Examination Form and bring to your Medical Provider for completion; upload to the Patient Portal. We will also accept the Medical Provider's form. Physical examination should be performed within the past 12 months.

Due Dates

All health records are required by August 1 for fall enrollment and January 1 for spring enrollment.

Failure to submit mandatory health records will result in a hold on your registration.

Complete and upload forms via the secure Patient Portal

Questions?

Please call us at 978-934-6800 or contact us with any questions.