Health Services

Health Services Forms

All new (Freshman and Transfer) students are required to submit their immunizations and the Health Report and Physician's Certificate (6 page document filled out by you and your Health Care Provider) to Student Health Services via regular postal mail, scanned and emailed to hse@purchase.edu or faxed to (914) 251-6388.

Meningitis Information Response Form

Immunization Record Form (the immunization record does not have to be on our form)

Physical Examiniation THIS IS A REQUIRED DOCUMENT FOR ALL NEW STUDENTS (FRESHMAN AND TRANSFER) If you have had a physical exam within the past 18 months you do NOT need to get another one. Have your doctor fill out the form using the information on your past physical.

Athletic Health History

Men's Health Questionaire

Women's Health Questionnaire

Medical Leave of Absence Reenrollment Form

Medical Leave of Absence Information Form