Immunization Requirements Effective June 1, 2020
Ensure compliance with the student health clinic's immunization requirements by submitting necessary documentation including titers and vaccination records. Learn about the Hepatitis B, MMR, and Varicella immunity requirements.
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Effective June 1, 2020 Immunization Requirements
Student Health Clinic 855 Montgomery St. 3rd Fl. North Health Pavilion Fort Worth TX, 76107 817 735-5051 Contact Information studenthealth@unthsc.edu Click here for more information Immunization Requirements
Uploading Documents Medicat is our immunization compliance partner, you will enter your records into their system Instructions can be found on their website Medicat Connect
Uploading Documents Be sure to enter correct dates and then upload supporting documentation for each requirement into Medicat Medicat How To
A titer is an antibody blood test that measures your immunity to a disease Quantitative titers are required Qualitative titer will not meet this requirement What is a titer? Upload lab report, enter results positive or negative For more information contact us studenthealth@unthsc.edu
What information do I need to submit? Immunization requirements
Hepatitis B Immunity Titer showing immunity. A positive result is considered consistent with immunity (sample lab report for illustrative purposes only)
MMR Measles, Mumps & Rubella Titer showing immunity A positive result is considered consistent with immunity (sample lab report for illustrative purposes only)
2 vaccinations or Titer showing immunity Varicella Chickenpox
Varicella Chickenpox History of Chickenpox Is not proof of immunity You must have a positive titer lab report or proof of 2 vaccines at least 4 weeks apart to meet this requirement
1 vaccination within the past 6 years Tdap Vaccine Tetanus, Diphtheria, A Cellular Pertussis Tetanus, Diphtheria, A Cellular Pertussis Td, DPT, or DTaP will not meet this requirement
2-step PPD skin test QuantiFERON TB Gold/ T-spot blood test Only required for students with positive PPD results or history of positive PPD Tuberculosis Screening TB (2 PPDs taken 1-3 weeks apart) Required for all 1st year students(Unless you have history of positive skin test) Students with history of positive PPD skin test must have the QuantiFERON TB Gold blood test
Documentation of latent TB infection with or without treatment or treatment for active infection Additional 1-step PPD, QuantiFERON TB Gold or symptom screening (based on your 1st year requirement) dated within 3 months of clinical rotations start date Required for ALL 3rd year students Tuberculosis Screening TB Continued Additional symptom screening and current chest x-ray may be required depending on history
You do NOT need a skin test if you tested positive in the past You will need a QuantiFERON blood test or symptom screening depending on history Please contact the Student Health Clinic to determine which screening is right for you studenthealth@unthsc.edu Dates and times will be announced once classes resume on campus Be sure to check your student email or The Daily News for scheduled events Free TB Skin Test Events
Influenza Vaccine One vaccination annually During Flu season
UNTHSC form is recommended, and available on line Other forms submitted must have similar information Medical Records Last name Home address Social Security number College (circle): TCOM GSBS SPH In Case of Emergency, Notify: Name Home address Work address History Acne ADD/ADHD AIDS, ARC, or positive HIV Current Past Never Allergies Current Past Never Anemia Current Past Never Anxiety disorder Current Past Never Asthma Current Past Never Back problems Current Past Never Bladder infection (cystitis) Current Past Never Bleeding trail/sickle cell Current Past Never Bronchitis- chronic Current Past Never Cancer (location) Current Past Never Chlamydia Current Past Never Colitis Current Past Never Condyloma (genital warts-HPV) Current Past Never Depression Current Past Never Diabetes Current Past Never Drug dependency Current Past Never First name Middle initial Date of birth City State Zip Home phone number Medical History & Physical Exam Biological Sex (circle): Male Female Gender Identity: Physician Assistant PT Pharmacy Relationship City State Zip Home phone number Submitted PE forms must have official clinic or provider stamp City State Zip Work phone number GSBS and SPH students are EXEMPT from this requirement Current Past Never Current Past Never Current Past Never Current Past Never Current Past Never Hypoglycemia (low blood sugar) Infectious mononucleosis Irritable bowel disease Kidney infections/stones Current Past Never Knee injury Learning disability Current Past Never Migraine headache/Vascular H/A Current Past Never Obesity (more than 20 lbs. overweight) Current Past Never Ovarian cyst Current Past Never Pelvic infection Peptic ulcer (gastric or duodenal) Current Past Never Phlebitis Current Past Never Pneumonia Current Past Never Rheumatic fever Current Past Never Rheumatoid arthritis Current Past Never Sinus problem- chronic Current Past Never Suicide attempt Current Past Never Syphilis Current Past Never Thyroid problem Tension headaches Current Past Never Current Past Never Current Past Never Current Past Never
You will NOT be able to register for upcoming classes unless all requirements have been met. Deadline for compliance Please contact Student Health w/any questions. Open 7 am-4 pm Monday & Thursday 8 am-5 pm Tuesday, Wednesday, and Friday 817-735-5051 StudentHealth@unthsc.edu
Welcome We are here to assist you in completing your immunization requirements. Please contact us with any questions
