The staff of Health Services would like to welcome you. The clinic mission is to provide for short-term, acute illnesses and injuries. Primary care services are provided with an emphasis on wellness and prevention, including allergy injections, routine, and travel vaccines.
Belmont University requires that all students submit a completed Belmont University Medical History Form, Immunization Record, and verification of health insurance by the end of your individual Foundations session prior to Welcome Week.
Completing the Health Form and Immunization Record
The confidential Health Form and Immunization Record is housed within Health Services’ secure portal. Please answer every question in the Medical History and submit. Complete the Immunization Record from your own vaccine records as accurately as possible. Please click this link to activate the form/s.
Steps to completion:
- Sign into MyBelmont with your username and password. (If you need to create your MyBelmont [BIC] account click here for instructions.)
- Answer every question in the Medical History and submit it.
- Complete the Immunization Record from your own vaccine records and submit it.
- Submit a paper copy of your immunization records and a front/back copy of your insurance card to one of the below:
- Mail to Health Services, 1900 Belmont Boulevard, Nashville, TN 37212
- Email to firstname.lastname@example.org
- Fax to Health Services at 615-460-6131.
IMPORTANT: Health Form and Immunization Record must be completed and all documentation received to avoid a registration Hold.
CAN NOT ACCESS THE FORM?
The Online Health Form and Immunization Record is only available to deposited students. Students’ Health Services account will be activated within 1 week of Admissions deposit. Upon activation of the form, if a message says, “cannot authenticate log in”, please try again the following week. Please notify Health Services if this occurs for more than one week.
Paperwork and documentation help
Immunization records: Students will need their childhood immunization records to complete the Immunization Record. If the student no longer has a copy of them, the records can be obtained from their primary provider, the health department, a high school, or previous university.
Current requirements for all students include:
- Tetanus or TDap booster within 10 years
- Two Measles,Mumps,&Rubella vaccinations for those born after 1956 (or positive blood tests)
- Three doses of Hepatitis B (or positive blood test)
- Meningococcal vaccine for students living in the dorm
- Two doses of chickenpox vaccine, or a positive blood test, or provider documented date of the disease.
- TB skin test only if warranted (see the Health Form)
Current health insurance coverage: Please provide a copy of current health insurance coverage ( back and front of card) for confirmation.
Specialty Requirements for Health Science Programs
Students in College of Health Science programs may have additional requirements; please speak to your advisor for details.
Consultation during Foundations
For your convenience, Health Services will be available for consultation by appointment during Foundations regarding the online forms and required vaccinations. To take advantage of this opportunity, please call 615-460-5506 to make an appointment for a consultation or for vaccinations information. Please book your appointment prior to Foundations. We are also happy to answer any questions you may have about our services, referral to specialists, or specific health concerns.
Health Services does not bill insurance, but will accept cash or check, credit or debit for payment.
Immunization pricing available by telephone at 615-460-5506.