Student Health & Wellness Center

Johns Hopkins University

3400 N. Charles St.

Baltimore, MD  21218

410-516-8270

www.jhu.edu/~shcenter

Instructions for Completing Your Pre-entrance Health Form Requirements

Graduate/Post-doctoral/Visiting Students Only:

Please note:  All entering students are required to provide proof of immunity to certain communicable diseases and submit to the Student Health & Wellness Center a completed pre-entrance health form prior to registration.

The due date for compliance with the University’s immunization policy is July 1.

Please print the following four forms:

Page 1 - Pre-entrance health form-Immunization Page – to be

               completed by your health care provider.

Page 2 - Important Information Regarding Your Immunization Requirements

Page 3 – Medical History form (to be completed by you)

Page 4 - Medical Insurance Information & Consent to Medical and/or Surgical Procedure

                (to be completed and signed by you, or

              your parent/guardian if you are < 18 years of age)   

Return all forms—your completed pre-entrance health form including personal information, medical history, insurance information and signed consent, along with the immunization form signed by your health care provider, in the self-addressed return envelope mailed to you by your department no later than

July 1.  If you do not have the self-addressed envelope, our address is listed at the top of this page.

If you have any questions, please feel free to contact the Student Health & Wellness Center at 410-516-8270.

Thank you for your cooperation.