Health Forms & Immunizations
The following forms are available via the student health portal. Click the form link, log in to the portal, and go to 'My Forms' for access.
- Health Form
- Meningococcal Vaccination Response Form (PDF)
- Immunization Release Form
- Under 18 Permission to Treat (PDF)
- Patient Rights and Responsibilities
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Immunization Requirements: New York State Public Health Laws 2165 & 2167
Measles, Mumps and Rubella: New York State Public Health Law Article 21, Title VI, Section 2165
In accordance with NYS Public Health Law 2165, any student born after January 1, 1957, must provide proof of immunity to measles, mumps, and rubella. Failure to provide proper documentation to Health and Wellness Services will result in dismissal from Alfred State.
Records may be located at the last college or high school attended or at the family doctor's office.
Summary of Proof of Immunity to Measles, Mumps, and Rubella
Doses required of live virus vaccine: MMR (first dose on or after first birthday)
- Measles
Two doses at least 30 days apart OR
Diagnosis of disease by a physician OR
Serologic evidence of immunity (Titers) - Mumps
One dose OR
Diagnosis of disease by a physician OR
Serologic evidence of immunity (Titers) - Rubella
One dose OR
Serologic evidence of immunity (Titers)
Meningitis: New York State Public Health Law (NYS PHL) §2167
Effective January 1, 2017, NYS Public Health Law 2167 requires all colleges/universities to distribute information about meningococcal disease and vaccination.
According to this law, each new student is required to:
- Provide proof of at least 1 dose of meningococcal ACWY vaccine within the last 5 years or a complete 2- or 3-dose series of MenB OR
- A signed waiver form refusing the meningococcal vaccine