Many health programs require you to fill out a health record before you can enroll
in the program. These health records disclose health history, immunizations and information
of that nature.
They are collated by the Health Records Office.
Health Records Office
Union Hall, Room 132
Hours of Operation
Monday, Tuesday, Thursday
8:30 a.m. - 5:00 p.m.
8:30 a.m. - 6:00 p.m.
8:30 a.m. - 4:30 p.m.
Our office has relocated to the first floor of Union Hall Room 132 as of Monday September
If you are unable to receive Tuberculosis (TB) Skin Testing, one of the blood tests
listed below may be used as an alternative:
To all students wanting to enroll or currently enrolled in NURC 1101
Due to the current mumps outbreak, it is strongly advised that all NURC 1101 students
provide health records with proof of 2 MMR vaccines or positive MMR titers. This may
be required to attend clinical.
Most of these forms are in the Adobe Acrobat format and require a browser plug-in
to view. Download Adobe pdf reader.
For detailed information on health record requirements, please read the Health Record Fact Sheet.
Health Record Submission Deadlines
Students who submit completed health records by the stated deadline will be given
clearance to register starting at 12:01 a.m. on "day one" of registration.
For students who submit completed health records after the stated deadline, please
allow between 5 -10 business days for processing and clearance to register.
||February 6, 2015
||April 3, 2015
||October 09, 2015
Health Record Forms by Program (.pdf)
Clinical Laboratory Assisting (CLA)
EMT and Firefighter
NURC 1101 Nurse Aide Training Program (This course is a prerequisite for the following programs: Nursing, Practical Nursing,
Respiratory, Sterile Processing and Surgical Technology)
Practical Nursing (Pre-Nursing students should fill out the NURC 1101 record)
Nursing, Respiratory, Radiography, Surgical Technology, Sterile Processing or Medical
Assisting (Pre-Nursing, Pre-Respiratory, Pre-Surgical Tech or Pre-Sterile Processing students should fill out the NURC 1101 record)
Annual Health Evaluation
Health History Form
Latex Reaction Form
Needle Stick Report
Physical Exam Form
Physician Certification Form
Supplementary Immunization Record
TB Test (Single Step)
TB Test (Two Step)