Student Health Records

Health Record

All students - full-time, part-time, non-degree, exchange, auditing a class, etc. - are required to have a completed Comprehensive Student Health Record on file at the Health Center. The Health Center forms are only required upon admission and do not need submitted each year. Failure to do so will preclude students from class registration and limit access to Student Health Services. All completed health records will include: (page 1) Biographical data, Emergency Notification, Signatures for the Consent for Treatment and Authorization to Release Medical Information sections; (page 2) A signature at the bottom of the Mental Health History section; (page 3) a head-to-toe physical and TB Risk Assessment to be filled out by a health care provider; and (page 4) a completed immunization record.

Immunizations for all full-time students include MMR (2 doses), Tetanus (within the last 10 years), Hepatitis B (3 doses), Meningococcal/meningitis (2 doses if 1st dose given before age 16), and Varicella/chicken pox (2 doses).

Immunizations for part-time students (less than nine credits) include MMR (2 doses), Tetanus (within the last 10 years) and Varicella/chicken pox (2 doses). **Students going on to become full-time will be required to provide documentation for the following: Hepatitis B (3 doses), Meningoccal/meningitis (2 doses if 1st dose given before age 16) and a TB Risk Assessment Form (available at Student Health Services).

All immunization requirements/recommendations are in accordance with the Pennsylvania Department of Health, The American Academy of Pediatrics, The American College Health Association and the Advisory Committee on Immunization Practices.


If a student is over 18 years of age all medical information is, by law, confidential. No information will be given to parents, friends, college administrators or professors without consent from the student.

Privacy Policy

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Student Health Services is dedicated to the protection of confidential patient health information. The Health Center Staff makes your privacy a high priority. Each time you visit the Health Center we make a record of the care and services provided. This record is necessary so we can provide quality health care to you as well as meet our obligations to certain state and federal laws. This notice will explain some but not all ways we may use and/or share health information. This notice will also describe your rights to access and control your medical record. We are required by law to keep your health information private. This protection includes oral, written, and electronic private health information. We are required by law to give you this Notice and to follow its present terms.

We reserve the right to change our privacy practices and the terms of this Notice provided these changes are permitted by law. We have the right to make these changes effective for all health information we have about you, including information created or received prior to the change. Before we make significant changes to our privacy practices, we will change this notice and make a copy available on request. This Notice is in effect August 1, 2003 and will remain in effect until changed.

Uses and Disclosures of your medical information:

In the following instances health information may be disclosed without your express authorization:

  • Treatment - Health Services may use/disclose your health information to provide treatment, coordinate services and manage your continued health care.
  • Payment - Health Services may use/disclose health information for the purpose of receiving payment or obtaining reimbursement to you. This may also include contacting your insurer to verify benefits or to obtain the needed authorization for treatment.
  • Health care operations - Health Services may use/disclose health information to perform health care operations such as but not limited to quality assessment & improvement activities, employee performance appraisals, risk management, employee training, obtaining accreditation/ licensure/ certificates.
  • Appointment reminders - The Health Center may use/disclose health information to the extent of reminding you of an appointment or provide you with information on alternative treatments or other services which may be of interest to you.
  • Notification & Disaster relief - The Health Center may release health information in contacting a friend or family member who is involved in your care concerning your location and general condition unless you specifically ask the staff not to share this information. Health Services may also release health information to disaster relief organizations.
  • As required by law - Including, but not limited to, Health Services will release your health information as required by state and/or federal law as applicable for the purposes of public health, abuse/neglect/domestic violence, legal proceedings, national security, and law enforcement.
  • Military Activity - The Health Center may use/disclose health information if you are in the armed forces and is required by command authorities or for reasons of benefit determination by the Department of Veteran Affairs.
  • Worker compensation - When necessary to comply with laws relating to workmen's compensation or similar programs, Health Services may release health information.
  • Medical examiners, coroners, funeral directors - Medical information may be used/disclosed by Health Services to Funeral Directors, Medical Examiners, Coroners or Organ procurement organizations to aid them in carrying out their duties.

Disclosure without authorization: When information is required to be disclosed without your authorization, Student Health will provide the least amount of information necessary to satisfy the purpose of the disclosure.

Other uses and disclosures

Student Health Services will release patient information for purposes other than those above with a written authorization signed by you. Verbal permission will be accepted only under certain circumstances when written authorization can not be practically obtained and will be well documented in your chart. You may withdraw your authorization, in writing, at any time. Your withdrawal will be effective upon our receipt of your written request.

Patient health information rights:

  • You have a right to a paper copy of this Notice even if you have received it electronically.
  • You have the right to request a restriction on certain uses/disclosures of your health information. This request must be in writing. We are not obligated to honor your request. If we do agree to your restriction we will not use these restrictions in cases of emergency.
  • Your have the right to examine your medical record when nursing personnel are available to review the file with you. You have the right to receive a copy of your medical record. This request must be in writing. If you are denied access to your medical records we will contact you in writing and you will have the opportunity to ask the denial be reviewed.
  • You have the right to request your record be amended if you feel it is incorrect or incomplete. This request must be submitted in writing. For certain reasons we may deny your request. If your request is denied you will receive a written explanation of the denial along with an opportunity to file a statement of disagreement which will be added to your record.
  • You have the right to request alternate ways of communicating with us regarding your private health information.
  • You have the right to receive an accounting of any disclosures after August 1, 2003 that were not for the purposes of treatment, payment, health care operations, or disclosures you authorized.

Questions and complaints

Questions regarding this notice, our privacy practices or your rights can be addressed through the Nurse Director of Student Health Services.

Complaints can be filed, in writing, with the Nurse Director of Student Health Services, the Dean of Student Affairs, or the Department of Health and Human Services. There will not be a penalty for filing a complaint.