Immunization and Health Forms
All students, full time and part time, graduate and undergraduate, must submit an immunization record.
The form must be completed with your registration/acceptance to the University. It must be signed and stamped by your health care provider or you may attach a copy of records from another school or physician office.
Immunization records are required prior to the start of classes. The immunization form must be turned in by July 15th for students starting in the fall semester and by Dec 15th if starting in the spring semester.
Please fax to 860.768.5140 or by email to IMRECORDS@hartford.edu.
If your provider will not fill out the form without a physical and will only provide a printout of immunizations, you must still fully fill out our form and attach the records. Please note that online learners do not need to meet the immunization requirement.
Requirements are based on The Connecticut Department of Public Health.
What are the requirements?
The state of Connecticut mandates that all students supply the following information:
- All students must show proof of two MMR vaccines (measles, mumps, rubella).
Individuals are exempt if born before Dec. 31, 1956.
- All students and transfer students beginning Jan 1, 2010 must show proof of two varicella (chicken pox) vaccines. (Individuals born in the United States before Jan. 1, 1980 are exempt)
- Proof of Meningococcal vaccination (Menactra) within five years of entry to the University is required for all residential students prior to room assignment. No student may move into campus housing until this requirement is met. Even if not living on-campus, we strongly recommend that all students be vaccinated against this disease. If it has been more than five years since your immunization, you will need a booster shot.