Dear New Student,
Welcome to Sacred Heart University! We hope your experience here will be a healthy and happy one.
The State of Connecticut requires that we collect some basic health information before you begin your studies. All new students, unless you are
a distance learner (online classes only), must submit these forms. It is your responsibility alone to make sure that we have received all the
required information – failure to comply with the State requirements will result in your student account being blocked, prohibiting you from
registering for classes AND entry into university housing.
Please read the information below carefully and completely and follow all instructions. Feel free to call us with any questions or concerns at
203-371-7838 or email us at email@example.com.
A. Checklist: Please use this checklist to assist you in completing the New Student Health Form
Print out this form in its entirety.
Complete Sections I and IV (Personal Information and Tuberculosis High Risk Screening Questionnaire).
Bring the form to your healthcare provider and have them fill out Sections II, III, and V (Immunization History, Clinician Information, and TB
Screening Tests). The New Student Health Form must be signed, dated and stamped by your healthcare provider.
Scan or take a photo of the completed forms (and all supporting documents given to you by your healthcare provider).
Log in to your Student Health Portal (https://myhealth.sacredheart.edu) with your SHU username and password and follow all
instructions on the home page. You will be required to upload this form to the Portal. DO NOT MAIL, EMAIL OR FAX YOUR FORMS!
Await review and verification of your uploaded forms (up to 5 business days), then make sure to check your messages in the Student
Health Portal (“Messages” tab) or your SHU email and respond to any requests for further information or corrective action.
All health forms must be submitted by JULY 15
FOR FALL SEMESTER (or 4 weeks prior to the start of classes for all other start dates)
B. Required Vaccinations/Screening
The following are required by the State of Connecticut and Sacred Heart University:
1. MMR (Measles, Mumps and Rubella) Vaccine: Two doses of each Measles, Mumps and Rubella vaccines (or the combined MMR
vaccine) administered at least 28 days apart with the first dose ON or AFTER your first birthday OR evidence of immunity to Measles,
Mumps and Rubella via blood titers – lab reports are required. Required for all students born after 1956.
2. Varicella (Chicken Pox) Vaccine: Two doses administered at least 28 days apart with the first dose ON or AFTER your first birthday OR
documentation of date of Varicella disease signed by your healthcare provider OR evidence of immunity to Varicella via blood titers –
lab reports are required. Required for all students born after 1979.
3. Meningitis ACYW Vaccine: One dose within the past 5 years only if you will be living in the residence halls.
4. Tuberculosis (TB) Screening Questionnaire: You must fill out this questionnaire and based on your answers, you may require skin or
blood TB testing.
For information on exemptions to the required vaccinations, please see the CT State Department of Public Health website section on
Immunization Laws and Regulations: https://portal.ct.gov/DPH/Immunizations/Immunization--Laws-and-Regulations.
C. Recommended Vaccinations
The following vaccines are recommended by Sacred Heart University, however you are not required to provide documentation that you have
received them: Hepatitis A, Hepatitis B, HPV, Meningitis B, and Tdap.
D. Programs Requiring Additional Health Forms
Some students are required to submit additional health forms for their specific program of study or sport. For instance, D1 athletes must submit
NCAA health forms to the Athletics Department, Nursing and some health science students must submit “CastleBranch” forms to their program,
and so on. Your program will notify you about any additional required health forms. Even if you have submitted health forms to your program
of study or to Athletics, you are still required to submit health forms to Student Health Services.
E. Minor Consent Form
If you will be under the age of 18 when you arrive on campus, you must have a parent or guardian fill out the “Minor Consent Form” and upload
it to your Student Health Portal in order for you to access Student Health Services. Please see the last page of this form.