Required Health Forms | �鶹��ý��

Required

FORMS

TIPS FOR COMPLETION

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You must login using your Ave Maria sign-on; if you have any trouble logging in, please contact the IT Helpdesk at 239-280-2585 or IThelpdesk@support.avemaria.edu.
If you are under the age of 18 at time of completion, you will be prompted to enter an email address for your parent/guardian; once the form has been submitted
We accept the following file types: PDF, PNG, JPG, JPEG, and GIF. Normally, photos taken on a phone in one of these formats are fine, as long as all information indicated above can be seen clearly in your photos. Do not submit HEIC files!!

If you have any questions about the forms listed above, please contact StudentAffairs@avemaria.edu.

ADDITIONAL FORMS FOR VARSITY & NON-VARSITY STUDENT ATHLETES

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In addition to the forms required by all students, all enrolled student athletes must also complete the following forms prior to arriving on campus. Students who neglect to complete their health forms in a timely fashion will not be allowed to participate in practices until those forms are submitted. The forms are listed and linked below; click on the name of the form to access.

If you have any questions about the above forms for student athletes, please contact SportsMedicine@avemaria.edu.

HEALTH FORMS FOR RETURNING STUDENTS

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There are three forms that all degree-seeking students must complete EVERY YEAR. Failure to complete these forms by the start of the semester may result in the student’s account being placed on STOP, which will prevent registration for the following semester.

The forms that must be completed are listed and linked below – click on the name of the form to access.

Please review the “Tips for Completion” below before submitting your forms, as improperly completed forms will be rejected.

For assistance or clarification, please email The Office of Student Affairs at StudentAffairs@avemaria.edu.

REQUIRED HEALTH FORMS FOR NEW STUDENTS

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There are four forms that all degree-seeking students must complete prior to their first day of classes. Failure to complete these forms by the start of the semester may result in the student’s account being placed on STOP, which will prevent registration for the following semester.

The forms that must be completed are listed and linked below – click on the name of the form to access.

Please review the “Tips for Completion” and “�鶹��ý�� Immunization Requirements” below before submitting your forms, as improperly completed forms will be rejected.

This form is collected annually, and is used to collect information regarding injury, allergies, and illness.
This form is collected annually, and is used to collect emergency contact information.
This form is collected annually, and is used to collect health insurance status.
Student athletes MUST include a copy of the front and back of their health insurance card; non-athletes may choose to include their card information for emergency purposes, if they wish, but ALL students must complete the form, whether they have insurance coverage or not.
This form is collected once, and remains on file as long as the student is enrolled at AMU.

For assistance or clarification, please email The Office of Student Affairs at StudentAffairs@avemaria.edu.

Requirements and Questions for

IMMUNIZATION

WHAT HAPPENS IF I FAIL TO SUBMIT MY HEALTH FORMS PRIOR TO ARRIVING ON CAMPUS OR ENROLLING IN COURSES?

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A hold will be placed on your student account preventing registration for the following term until you have completed submission of your health forms.

DOES THE �鶹��ý��IMMUNIZATION HISTORY FORM HAVE TO BE COMPLETED BY A HEALTHCARE PROVIDER?

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If it is your sole form of documentation for the vaccines received, then yes.

WHAT SHOULD I DO IF I HAVE RECEIVED ONE OR MORE OF THE VACCINES, BUT NOT THE OTHER(S)?

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If you haven't completed one of the named vaccines you can either receive it and have your doctor complete the Immunization History Form verifying this or if you chose not to receive the named vaccine, you can waive the vaccine by completing the Immunization Waiver Form.

WHAT COUNTS AS AN ACCEPTABLE IMMUNIZATION RECORD?

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An acceptable immunization record should have two identifiers (i.e. patient name and date of birth), plus type, date, and outcome of each vaccine/titer administered. There is no set format for these records, but the source must be one of the following:

A copy of your original immunization records.
An immunization record issued by a clinic, physician’s office, or state health department.
An immunization record from another school, provided it is on official letterhead from the school.

OVERVIEW

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�鶹��ý�� requires that ALL students provide evidence of , , and immunization, or else submit a signed waiver declining receipt of vaccinations, after being made aware of the risks associated with these diseases. Completed vaccination usually involves a series of two shots for MMR, and three shots for Hepatitis B.

To submit proof of immunization, students may:
Have their healthcare provider complete the �鶹��ý��Immunization History Form (found ), uploading the completed form as an attachment, or
Upload and attach acceptable immunization records otherwise (see below for further details on what constitutes “acceptable”).
To WAIVE the immunization requirement, students must complete the �鶹��ý��Immunization Waiver Form, found .

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REQUIRED HEALTH FORMS