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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.

Health and IMMUNIZATION FORM

A physical exam is not required.

Once you have filled in the form and saved it, click the “Submit” link below to upload it via Etrieve. You will be prompted to log in with either your Elmhurst eNumber or via Microsoft or Google (please see more instructions in the FAQ section on this page).

Submit Your Completed Form

Required Immunizations

  • MMR (measles, mumps and rubella)—two doses required after 1 year of age
  • Meningitis (last dose must have been received at age 16 or older; not necessary for students 22 years and older)
  • Tetanus/Diphtheria/Pertussis (Tdap) within the past 10 years
  • Tuberculin skin test (PPD)—required for new international students

Recommended Immunizations

  • Hepatitis B
  • Varicella (chickenpox) if no history of the disease

Frequently Asked Questions

Start by clicking the “Health and Immunization Form” button above on this page and fill out the PDF. Then:

  • Click on “Submit Your Completed Form.”
  • If you are a current student or admitted applicant, click the Okta (blue “O”) icon to securely log in. Use your eNumber and password to access the form, fill it in and submit it electronically.
  • If you are not a student or admitted applicant, please log in using your personal Gmail or Microsoft account to begin this process. You will need to provide the student’s information to submit the form.
  • 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: studenthealth@elmhurst.edu

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. Vaccines, TB skin tests and blood tests are available in 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 (use the “Submit Your Completed Form” link above).

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.

Medical Exemption Form

Religious Exemption Form

The Wellness Center

Niebuhr Hall, 010

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