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Incoming Students

Required Health, Immunization, and Consent Forms

Required Immunizations & Health Information

Detailed Vaccination Requirements

Health History Form

Consent for Treatment

Meningitis Response Form

Immunization Record Release

If you need a copy of the immunization records you provided to the Wellness Center sent to another institution, a formal request and consent are required. New York State law requires us to maintain medical records for six years from the date of last visit. Additionally, New York law requires that information contained in medical records be held in strict confidence and not be released without your written authorization. If you would like a copy of the immunization records you provided to Roberts Wesleyan University, please complete this authorization and request form. An uploaded copy of your photo identification is required to complete the request.

We appreciate your patience and understanding that your request may take up to 10 business days to process.

Immunization Form