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.
If you are unable to receive Tuberculosis (TB) Skin Testing, one of the blood tests
listed below may be used as an alternative:
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.
||October 7, 2015
||February 5, 2016
||April 4, 2016
Health Record Forms by Program (.pdf)
Clinical Laboratory Assisting (CLA)
EMT and Firefighter
NURC 1001 Nurse Aide Training Program (This course is a prerequisite for the following programs: Nursing, Practical Nursing,
Respiratory, Sterile Processing and Surgical Technology)
Nutrition & Dietetics
Practical Nursing (Pre-Nursing students should fill out the NURC 1001 record)
Nursing, Respiratory, Medical Imaging, Surgical Technology, Sterile Processing or
Medical Assisting (Pre-Nursing, Pre-Respiratory, Pre-Surgical Tech or Pre-Sterile Processing students should fill out the NURC 1001 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)