Required Medical Entrance Forms
Depending on what type of student you are (resident, commuter, nursing, or off-site), there are different requirements. Please complete and submit the appropriate forms.
Off-site students: Students who are taking classes at an off-site location (FDU Off-Campus Sites explained) only need to submit the Off-Site Student Immunization Record. If you are taking classes on the Metropolitan or Florham Campus you are NOT an off-site student. You must submit the COMMUTER packet of forms.
Immunization requirements for resident, commuter, and nursing students
|MMR||✔||✔||✔ Titers Required|
|Varicella||✔||✖||✔ Titers Required|
|Hepatitis B||✔||✔||✔ Titers Required|
|Influenza||✖ Encouraged Every Fall||✖ Encouraged Every Fall||✔|
Entrance form packets for download
- Download RESIDENT STUDENT PACKET (PDF)
- Download COMMUTER STUDENT PACKET (PDF)
- Download NURSING STUDENT PACKET (PDF)
- Download OFF-SITE STUDENT FORM (PDF)
Individual forms for download
- Download Cover Letter (PDF)
- Download Student Profile (PDF)
- Download Health History (PDF)
- Download Physical Examination (PDF)
- Download Resident Student Immunization Record (PDF)
- Download Commuter Student Immunization Record (PDF)
- Download Nursing Student Immunization Record (PDF)
- Download Off-Site Student Immunization Record (PDF)
- Download Meningococcal Vaccine Questionnaire (PDF).
Important information to remember when submitting the required entrance forms
- Mail your own Health Forms and do not rely on doctors’ offices and schools to mail it for you. Too often we never receive it.
- Do not fax us your health forms. Faxed health forms are often illegible and the pages can get easily misplaced.
- Please keep a copy of the completed forms for your personal record before mailing all original documentation to Student Health Services.
- Students will not be permitted to register for a class or to reside in FDU housing until the health forms and immunization records are completed and received.
- All forms submitted MUST be in English.
- Students who request a medical or religious exemption will be required to have blood titers drawn for Varicella, MMR, and Hepatitis B; and can choose to either have a CXR and/or a QuantiFERON TB gold test performed in lieu of a TB skin test. Please see the relevant State of NJ information.
Positive TB assessment form
|Symptom Assessment for Pulmonary Tuberculosis (TB) – Nursing Students Only|
Symptom assessment for pulmonary tuberculosis (TB)
This form is for nursing students with a history of a positive TB test. This form is to be completed at the time of the nursing student’s annual physical exam.
Medical records are strictly confidential and are not part of the academic records. Medical records are used exclusively by Student Health Services Metro to provide personalized care. Any information on these records or concerning a visit to Student Health Services Metro will not be released without written permission from the individual treated. Immunization records are an exception and are not confidential since your immunization status must be made available to New Jersey State Inspectors and select University offices in order to comply with New Jersey State Law.