Student Health Form
Download the Student Health Form Here
Dear Student,
The Health Services staff would like to welcome you to Belmont. As part of your entry into the Belmont community, we want to make sure that you are healthy and that we help you stay that way. Because of this, Belmont University requires that all students (full time, part time, undergraduate, and graduate) complete our health form before registering.
You will receive the health form in your admissions packet, and it is also available to download from our website (http://www.belmont.edu/healthservices). Hard copies of the form are also available in Health Services, Belmont Central, and the Admissions Office. The health form must be sent directly to Health Services prior to registration.
The form itself is divided into four sections:
- Demographic information
- Health Insurance Information
- Physical exam
- Immunization record
While we do not require the physical exam, we do recommend it. The vaccinations, however, are mandatory. Make sure that your provider signs off at the bottom of the health form.
All immunization requirements can be found on the health form, but they include the proof of two Measles, Mumps and Rubella vaccinations for those born after 1956; a series of (3) doses of the Hepatitis B vaccine; the Meningococcal Meningitis vaccine for students who will be living on campus; a Tuberculin skin test within the last twelve months; and a Tetanus injection within the past ten years. Students in the College of Health Sciences have additional requirements that are explained on the health form. All immunizations are offered through our clinic.
If childhood immunization records are not available, we accept proof of one MMR vaccination after 1989 or proof of immunity. Both the Hepatitis B vaccine and the Meningitis vaccine are strongly recommended but not required. If you choose not to have either of these vaccines, then you must submit a signed waiver located on the second page of the health form.The health form should be sent separately from all other admissions and registration forms. It has its own deadline and should be completed and returned directly to Health Services. Registration holds will be placed on the accounts of students who do not submit their completed form by the end of their first semester.
Please mail your completed health form to:
BelmontUniversity
Attn: Health Services
1900 Belmont Blvd.
Nashville, TN 37212
We are looking forward to meeting each of you, and please do not hesitate to call (615) 460-5506 if you have any questions.
Sincerely,
Katy WilsonDirector of Belmont Health Services
