Immunization Requirements and Medical History
All new students are required to submit a health history and proof of immunization for certain diseases. Our health and immunization form can be submitted electronically using the link below.
It is an Illinois State Law for all students who are enrolled at a post-secondary institution to submit a copy of their immunization record. A physical exam is not required. Please complete the health history form on the second page and submit it along with your immunization record. You may have your primary care provider, former high-school, or previous university fax your records to Student Health Services. If you are unable to obtain your immunization record, you will need to be re-vaccinated or have an immunity profile (blood test) done to confirm your immunity. Vaccinations, immunity profiles, and tuberculosis screenings are available at Student Health Services for a fee.
All forms must be submitted no later than June 1st for the fall term and December 1st for the spring term. Students with incomplete immunization records will be put on a “medical hold.”
REQUIRED IMMUNIZATIONS – Immunization records must include the requirements as stated below:
| MMR (Measles, Mumps, Rubella) | Two doses of the MMR vaccine administered on or after 12 months of age OR positive serum titers to all three diseases (attach lab report) |
| Meningococcal Conjugate (MenACWY) | Students aged 21 and younger are required to have at least one dose on or after 16 years of age |
| Tetanus-Diphtheria-Pertussis (DPT, DTP, DT, DTaP, Td, Tdap) | Any combination of three or more doses of Tetanus-Diphtheria-Pertussis. One dose must be a Tdap. The last dose (DTP, DTaP, DT, Td, or Tdap) must have been given within 10 years prior to the current enrollment term. |
| International Students Only: Tuberculosis Screening | Quantiferon Gold (QFG) blood test from the current enrollment year |
Once you have filled out the form and saved it, click the “Submit Your Completed Form” link below to upload it via Etrieve. Please refer to the instructions in the FAQ. If you are not a student or admitted applicant, see additional instructions in the FAQ section below.
Frequently Asked Questions
Here are instructions on how to submit your immunization record on Etrieve:
- Sign into the myElmhurst Portal
- Click and open the Etrieve app
- Click and open “Forms” on the left-hand side
- Folders will appear for each department – look for “Wellness Center” and click on “Health and Immunization Upload”
- Fill out the form, use the paperclip button at the bottom to attach your PDF form, and then click Submit
Immunization records can also be sent to Student Health Services via:
- Fax – (630) 617-3255
- Etrieve
- Dropped off in person at the Wellness Center, which is located on the lower level of Niebuhr Hall in Room 010
- Contact your former high school and have them email or fax us a copy.
- Contact your former four-year college/university and have them email or fax us a copy. (Note: two-year colleges do not require this record.)
- Contact your primary care physician and have them email or fax us a copy.
Email: [email protected]
Fax: (630) 617-3255
If you can’t find your immunization record, you will need to be re-vaccinated or have a blood test to confirm your immunity. All required vaccines and TB screen are available at the Wellness Center for a fee.
Yes. Download either the Religious Exemption Form or the Medical Exemption Form and complete it. (Note: Your primary care physician will need to complete part of the Medical Exemption Form.) To submit the exemption form, you will need to upload it to Etrieve.
Please note: You will still need to provide the Wellness Center with the health history section of the health and immunization form, even if you request an exemption.