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The Health Assessment Form is to be COMPLETED
FULLY. Do not leave blank spaces. Once the
Health Assessment Form is completed, a Health
Status Report Form (clearance) will be MAILED
to you and a copy will be sent to the School
of Nursing.
- INCOMPLETE forms received before July
1st, will be returned to be completed
and the student is to return the form
back to the Health Services Office within
two weeks. Students are required to pay
a $5.00 fee if the form is returned more
than once for further processing and to
receive a clearance.
- Once completed, the student will receive
a clearance. Students will receive ONE
clearance slip per year - additional copies
require a $5.00 fee.
- Students who submit a Health Assessment
Form after the designated deadlines (see
below) will be subject to a $5.00 late
fee. Annual requirements that expire during
the semester will not be accepted.
- Students are responsible for submitting
the APPROPRIATE REQUIRED FORM.
- RETURN BY MAIL!! Students who “drop
off” the form will receive a clearance
AFTER FIVE (5) DAYS.
- Your instructors will ask you to SHOW
THIS AS PROOF OF HEALTH CLEARANCE before
you are permitted to enter any clinical
agency. KEEP YOUR COPY.
DATE
OF FIRST CLINICAL COURSE HEALTH FORM
DUE
Summer May 1st
Fall July 1st
Spring December 1st |
HEALTH CARE AGENCIES WILL NOT PERMIT ANY
NURSING STUDENT WHO HAS CLIENT CONTACT TO
PARTICIPATE IN HIS/HER CLINICAL AREAS WITHOUT
A CLEARANCE FORM.
The Health Services Office provides the
clinical services required to complete the
Health Assessment Form for a nominal fee.
This includes immunizations, complete physicals,
titers, PPD screening, etc. In addition,
the CPR Health Care Provider/Professional
Rescuer Course is offered by the Health
Services Office. The schedule and registration
forms are available in the School of Nursing
and Health Services Office.
PUBLIC HEALTH LAW (NYS PHL) §2165-
ALL students, regardless of the program
enrolled in, born on or after January 1,
1957, must present documented proof of immunity
against Measles, Mumps and Rubella. This
is a mandate by New York State Department
of Health, Public Health Law, Chapter 2165.
IT’S THE LAW!
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