Forms

• Traditional Undergraduate Students State and SEU Medical Requirements
• Minor Consent Form
• Authorization to Release Medical Information from SEU
• Information data sheet.
• Medical History and Physical Forms filled out by your physician.
• The immunization requirements are as follows:
  • 2 measles vaccines
  • 2 mumps vaccines
  • 2 rubella vaccines
  • Meningitis vaccine (serogroup ACWY)
    • Students less than or equal to 23 years old and all resident students
    • Final dose must be administered at or after the age of 16 AND within 5 years of entry
  • ALL must read the Meningitis Vaccine Information statement. You must also complete and sign the Meningitis Information Sheet and return it to Health Services.
  • 3 Hepatitis B vaccines (or 2 dose series – Heplisav)
  • Inteferon-gamma release assay test (IGRA) or PPD/Mantoux testing (within one year)
    • PPD/Mantoux
      • Plant date and the read date is required.
      • Reading needs to be in millimeters of induration.
    • IGRA – copy of lab request required
    • If you have a history of a positive PPD/Mantoux or IGRA, you need a chest x-ray (within one year)./li>
  • Physician Forms and Guidelines for Requesting Medical Exemptions of Required Vaccines

Forms

Send or fax your completed forms to:

SEU Health Services
Founders Hall
2 Convent Road
Morristown, NJ 07960

Fax: (973) 290-4182.

Health and Immunization Requirements

The following are the basic requirements for the graduate and continuing studies students. Please refer to the instruction portion of the forms for more detailed information.

Please Note: SEU undergraduate alumni who are enrolling as graduate students must submit the current Health Form.

Questions?

For additional assistance, contact Health Services at (973) 290-4132.

• Graduate & Continuing Studies State of NJ & SEU Medical Requirements
• Authorization to Release Medical and Immunization Documents to SEU
• Authorization to Release Medical Information from SEU
  • Identification sheet
  • All must read the Meningococcal Vaccine Information Statement and complete and sign the Meningitis Information Sheet.
  • For students born after 1956, you must provide documentation of:
    • 2 measles vaccines
    • 2 mumps vaccines
    • 2 rubella vaccines
  • For students taking 12 or more credits in any semester, you must provide documentation of:
    • 3 Hepatitis B vaccines (or series of 2 Heplisav)
  • Physician Forms and Guidelines for Requesting Medical Exemptions of Required Vaccines

All potential athletes must in addition have a Pre-participation Athletic History, Physical and clearance completed by their physician prior to entrance and participation and within six months. In additional all athletes are REQUIRED to fill out Traditional Undergraduate Health Forms and Requirements.

Students who are transferring into Saint Elizabeth University’s Nursing Program will need to complete Traditional Undergraduate forms (see above) IN ADDITION TO THE NURSING DEPARTMENT FORMS FOR CLINICAL CLEARANCE.

Prior to starting any clinical rotation, all students must complete a clinical clearance process which includes obtaining: medical clearance, criminal background check, urine drug screen, malpractice insurance, and CPR certification through the American Heart Association. Students will not be allowed to attend clinical rotations if they have not fulfilled the necessary requirements for the Clinical Clearance Process.

Requirements need to be completed during the summer months before August 1.

For the initial medical clearance:

• Provide proof of the following vaccinations: Measles, mumps, rubella, varicella, Hepatitis B, Tdap, influenza, and Covid-19 vaccination and booster or one bivalent Covid-19 vaccine
• Quantitative titers for measles, mumps, rubella, varicella; Hepatitis B surface antigen; Hepatitis B surface antibody; Hepatitis B CORE antibody
• Documentation for baseline TB screening with either an IGRA (Interferon-Gamma Release Assay) blood test or two-step PPD
• History and Physical Exam with Healthcare Provider Attestation
• OSHA Respirator Medical Evaluation Questionnaire

Annual Medical Clearance

• History and physical with Healthcare Provider Attestation
• Annual influenza vaccine
• TB testing
• OSHA Respirator Medical Evaluation Questionnaire

Additional requirements may be added as per clinical agency requirements.

The Nursing Department has contracted with Sentry MD to store and maintain their student health forms. Once compliance tracking is ordered, health forms will be emailed to the student. To order compliance tracking, along with the required criminal background check and a urine drug screen, download the flyer.

For any questions, contact Dr. Ricci-Allegra at prallegra@steu.edu or (973) 290-4570.

 

Forms

• State of N.J. & SEU Physician Assistant Program Medical Requirements
• Authorization to Release Medical and Immunization Documents to SEU
• Authorization to Release Medical Information from SEU

Please download and print a copy of the Medical Requirement forms for the Physician Assistant Program which includes the following items:

• Required Form A - Health Form
• Required Form B - Immunization Record
• Required Form C - Meningitis Information Sheet
• Required Form D - Authorization to Release Immunization and TB Screenings

Please read the instructions carefully. Complete and send a copy of all required forms to:

SEU Health Services
Founders Hall
2 Convent Road
Morristown, NJ 07960

Immunization Info Line: (973) 290-4388
Fax: (973) 290-4182

• Physician Forms and Guidelines for Requesting Medical Exemptions of Required Vaccines

Questions?

For additional assistance, contact Health Services at (973) 290-4132.