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PURDUE UNIVERSITY STUDENT HEALTH CENTERIMMUNIZATION HISTORY FORM1. Please PRINT This form must be completed in English using MM/DD/BY format 2. Form must be signed by a provider 3. Upload in Medical.
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Purdue university immunization requirements FAQ
COVID-19. All Indiana University students, faculty and staff are required to have a COVID-19 vaccine and be fully vaccinated or have an approved exemption before coming to campus.
Face masks are not required outdoors on campus. Face masks are optional indoors on the West Lafayette campus, with the exception of health care settings and where contractually required.
Proof of COVID-19 vaccination and how to get vaccinated If you haven't already, we encourage anyone fully vaccinated against COVID-19 to submit proof of vaccination.
However, students are encouraged to monitor for symptoms and test for COVID-19 if they think they have been recently exposed before and after arriving to campus. Students who are experiencing symptoms of COVID-19 and need to schedule a test can do so through the Purdue University Student Health Center.
Additional information is also available on the following websites: TO SUBMIT IMMUNIZATION RECORDS: Mail to: College of Staten Island, Health & Wellness Services, 2800 Victory Blvd., Staten Island, NY 10314. Fax to: 718.982.2966. Email: HealthCenter@csi.cuny.edu.
Students and employees on the West Lafayette campus are strongly encouraged to submit proof of vaccination against COVID-19 to the university.
Required Immunizations Two (2) doses of MMR (Measles, Mumps, and Rubella) received AFTER 1st birthday. TDAP or TD booster within the last ten (10) years. Meningococcal Conjugate (MCV4) on or after 16th birthday. Two (2) doses of Meningococcal B Series (if 25 years and younger)*
Required Immunizations Two (2) doses of MMR (Measles, Mumps, and Rubella) received AFTER 1st birthday. TDAP or TD booster within the last ten (10) years. Meningococcal Conjugate (MCV4) on or after 16th birthday. Two (2) doses of Meningococcal B Series (if 25 years and younger)*
A. Login to your patient portal at myhealth.push.purdue.edu or on the PUSH website at purdue.edu/push. Once logged in, click the forms tab to locate the immunization information form.
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