Health Forms & Immunization Requirements

Physical Assessment Form

University of Evansville requires all full-time graduate and undergraduate students, including all international students, to provide their health history and immunization records. The physical assessment must be completed before the first day of class, otherwise the student may not be allowed to attend classes and will have a hold placed on their account and will be restricted from attending classes. Students will also not be allowed to access or register for classes the next semester.

Students should print the physical assessment and submit a signed form to the UE Health Center.

NOTE: The physical must have been conducted after August 2017 for class attendance in the fall of 2018 to be valid and must include the physician’s signature.

Required Immunization Records

It’s the law! Indiana law (IC-21-40-5) requires you to provide proof of your immunization status to be a college student. Information regarding religious or medical exemptions to immunizations is available from the Health Center.

  • Proof of two MMR (measles, mumps and rubella) vaccinations with dates
  • Proof of a TB skin test. The TB skin test must be conducted and results read in the United States within the last 6 months. The date and test results must be documented and submitted to the Health Center. Positive TB results will require additional action steps. Please contact the Health Center for more information.
  • Proof of Diphtheria/Tetanus (DT/tDAP) vaccination within the past ten years.
  • Proof of Meningitis vaccine or booster for those vaccinated before the age of 16.

Please contact the Health Center with any questions regarding these required records. It is important that all records are on file with the Health Center before classes begin on August 22, 2018. Students not in compliance with these requirements risk their eligibility to attend class and live in residential campus housing.

Office Phone:
812-488-2033

Office Email:
healthcenter@evansville.edu

Office Location:
Sampson Hall, 1800 Lincoln Ave, Evansville, IN, 47722