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.
The Health Records Office collects and managed health records forms.
Union Hall Room 132
|Hours of Operation||
Monday 10:00 a.m. - 4:00 p.m
*Closed 11/2/2022 for processing. If you need assistance please leave a voicemail and your call will be returned on or before 11/3/2022.
Health Record Submission Deadlines
* You may submit your complete record after the deadline, however, this may delay your ablity to register for classes by 10 business days.
Completed health records received by the stated deadline, will be processed, and given clearance to register in 1-5 business days.
Completed health records received after the stated deadline, will be accepted, processed, and given clearance to register in 5-10 business days.
|Spring 2023||October 3, 2022|
|Summer 2023||February 3, 2023|
|Autumn 2023||April 5, 2023|
If you are unable to receive Tuberculosis (TB) Skin Testing, one of the blood tests listed below may be used as an alternative:
Health Record Forms by Program
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.
- Laboratory Techniques for Health Industries
- Dental Hygiene
- EMS Paramedic
- EMT 1860
- Medical Laboratory
- 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
- Pharmacy Technician
- Practical Nursing (Pre-Nursing students should fill out the NURC 1001 record)
- Respiratory, Medical Imaging, Surgical Technology, Sterile Processing or Medical Assisting (Pre-Nursing or Pre-Respiratory students should fill out the NURC 1001 record)
- Veterinary Tech
- Annual Health Evaluation
- Covid Medical Exemption Request (only covid vaccines or exemption requests to be submitted to firstname.lastname@example.org)
- Covid Religious Exemption Request (only covid vaccines or exemption requests to be submitted to email@example.com)
- Latex Reaction Form
- Medical Release
- Needle Stick Report
- Physician Certification Form
- Supplementary Immunization Record
- TB Test (Single Step)
- TB Test (Two Step)