Instructions for Submission of Health Information Fall 2014 and Spring 2015
Incoming Fall 2014 and Spring 2015 students must complete several online forms and submit documents for verification purposes. Failure to meet the requirements will result in denial of student registration privileges. These forms MUST be submitted by July 1, 2014.
Important! Submission of your immunization information is a 3-step process, as outlined in the image below. Please follow the instructions carefully and complete each step in the following order to ensure that your records are processed without delays.
Step 1. See Your Healthcare Provider
Have your medical provider complete the Immunization Worksheet.
Please Note: The immunization worksheet must include your provider's signature with title and copies your original immunization records.
Step 2. Online Submission
Once logged in, go to FORMS and complete the 4 online forms:
- Notification of Private Practices
- Health History (Complete questions that pertain to you)
- Immunization (See instructions below)
- TB Risk Screening (please complete all questions)
Completing the online Immunization Form:
Enter the immunization information that your health provider entered on the Immunization Worksheet. You will need your Penn Key and password to access this site. If you have any questions about how to enter your immunizations, please feel free to call us at 215 746 3535, menu option #4.
Step 3. Send Fax
Once you have completed the online forms, fax the Immunization Worksheet and all other related documents to the Student Health Service. You can obtain the fax number when you access the online forms at here the SHS Portal. You will need your Penn Key and password to access this site.
IMPORTANT! Sending this information to us before you enter it online will greatly delay processing. Please go to the above link and complete the online forms before sending your Immunization Worksheet/records.
- Has your healthcare provider completed the other side of this form, including signing/stamping and contact information?
- Have you attached copies of original records/blood test reports with your Immunization Worksheet?
- Have you entered your immunization online before you have sent this to us by fax? If not you will have to contact us.
Frequently Asked Questions for Submission:
Frequently Asked Questions for Immunization