Health Services Forms

Assumption College requires that all new, full-time undergraduate students return completed Health Forms to either Student Health Services or Sports Medicine (if playing a D-II sport) no later than July 15th for fall semester enrollment and January 15th for spring semester enrollment. Within these forms, incoming students are required to submit documentation of required immunizations and proof of health insurance. Students who fail to submit required documentation will be prohibited from attending classes, living on campus, and/or practicing/playing a D-II sport.

New Student Health Requirements Checklist

Health Entrance Form (for all incoming undergraduate students)

Any student who is NOT planning on playing a sport should complete this Health Entrance Form. Failure to submit by the deadline will result in the student not being allowed to move onto campus housing or attend class.

This form is required to be on file for all incoming undergraduate students, and must be submitted no later than July 15 (fall enrollment) or January 15 (spring enrollment).Failure to submit by the deadline will result in the student not being allowed to move onto campus housing or attend class.

The Health Report requires students to also submit:

  • Proof of required immunizations or waivers
  • A copy of the student’s health insurance card (front and back)

Athletic Health Report

Any student who intends to play a D-II sport should complete the First Year Student Athletic Health Form instead of the Health Entrance Form. The form can be found at: Questions? Please call Sports Medicine at (508) 767-7238.

Immunization Medical or Religious Waiver

All medical exemptions must be verified with a letter from a qualified medical provider. It must specify which immunization(s) cannot be given and the specific condition that prevents the administration of the vaccine. A religious exemption is allowed if a parent or guardian submits a written statement explaining in reasonable detail that immunizations conflict with their sincere religious beliefs.

Philosophical exemptions are not allowed by law in Massachusetts, even if signed by a physician. Only medical and religious exemptions are acceptable.

(105 CMR 220.000 and M.G.L. c.76, ss. 15, 15C and 15D).

In the event of an outbreak of any of the vaccine-preventable disease on campus, students who waive immunizations are subject to being excluded from campus and classes until the period of communicability is passed, as described in the Reportable Diseases and Isolation and Quarantine Requirements (105 CMR 300.000). The College will not be responsible for any costs associated with missed classes or exclusion from housing during the period of communicability and that no refund will be made by the College.

Meningitis Information and Waiver

The meningitis immunization is required of all students who will reside in on-campus housing.

Authorization to Disclose Health Information

Students must complete this form in order to allow Student Health Services to disclose their health information to an individual of their choosing.

Review our Privacy Practices policy.

Dietary Accommodations Request Form

Students/Individuals interested in receiving dietary accommodations for allergies or medical conditions must complete the accommodation request form and submit relevant documentation.