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Required Incoming Student Health Forms

The Student Health Center staff welcomes you to Rowan University. In order to serve you more effectively and safely, we require that the following forms, explained below, be completed and returned prior to a student's first semester. These forms are currently packaged as one document and can be downloaded in PDF format.

PLEASE NOTE: Your health records must be complete including all of the following information or a "hold" will be placed on your records, preventing you from receiving grades or adding/dropping courses.

Undergraduate Student Forms

Graduate/Certification/CPCE Student Forms

1. Personal Information and Consent Form
A brief health history is to be completed by you and/or your parents. Also, this form includes emergency contact information, health insurance, and consent for treatment.

2. Physical Exam Form (required of all undergraduates)
A complete physical examination and laboratory tests give the Health Center a baseline for providing continuity of care.

• Urinalysis and Hematocrit/Hemoglobin are only required for athletes

3. Immunization Form

• 2 MMR (Measles, Mumps, Rubella) Vaccines after the 1st birthday and 30 days apart
• Hepatitis B - series of 3 (only for students taking 12 or more credits)
• Meningitis Vaccine (Menactra®) required prior to living in campus housing, and required of all athletes
• Tetanus in past 10 years - Intercollegiate Athletes

4. Meningitis Information & Response Form

5. TB Assessment and Screening Form

• PPD required for high-risk students and International students (even if you have a BCG Vaccine)

Send completed forms to:

Rowan University
Student Health Center
201 Mullica Hill Road
Glassboro, NJ 08028-1701

or FAX: (856) 256-4427

This packet will become part of your confidential medical record. The immunization form must be available for inspection by the state of Department of Health. The state Epidemiologist requires an annual report of compliance to the immunization law. The Health Center staff will review your submitted forms. If any information is omitted or incomplete, or falls in an unacceptable time frame, you will be notified via mail.