• Submit Health Clearance Form
  Information on obtaining the Health Clearance Form is given to students along with their acceptance packet. Complete the front page of this form to the best of your ability. The back page can be completed by your physician or, if you have your own personal immunization records, you can submit a copy of the records.
  
  
• Comply with State of Hawai'i tuberculosis clearance guidelines
  ALL students enrolled at UHM must have tuberculosis (TB) clearance. A negative TB skin test (PPD - Mantoux) within one year prior to your enrollment is required. Skin test results must be read in 48 to 72 hours and results documented in millimeters, i.e., 0mm. If positive, a chest x-ray is required. TB tests must be performed by a U.S. licensed provider.
  
  *Click here for an update on TB health clearance requirement.
  
  
• Returning or Transferring Students from a post-secondary school in Hawaii (i.e., UH Hilo, Community Colleges, Chaminade, HPU, etc.):
  • When you re-enroll in another post-secondary school in Hawaii, a copy of your original certificate shall meet the Tuberculosis requirements for certification.
  • The Tuberculosis certificate must be done in Hawaii for a post-secondary school.
  • Hawaii students with a history of a positive PPD and negative chest x-ray must complete and return the Tuberculosis Symptom Screening form.
    
    
• Provide documentation of immunity to measles, mumps, and rubella (MMR)
  
  • You need two live doses of measles vaccine, with at least one being an MMR (Measles, Mumps, and Rubella) vaccine.
  • Your first dose must have been given on or after your first birthday.
  • Your second MMR vaccine must have been given at least 4 weeks after the first vaccine.
  • Measles, Mumps, and Rubella immunizations may be waived if:
    • You have a blood test to prove your immunity to measles, mumps, and rubella. The measles, mumps, and rubella titers are needed, OR
    • You were born before 1957, OR
    • Your physician confirmed you had the MMR diseases. A written confirmation is required.

Note: Although not required for enrollment, it is highly recommended that students should also receive the following immunizations: a) Hepatitis A and B, b) Tetanus/Diphtheria and Pertussis, c) Polio and d) Meningococcal. We especially urge students who intend to live in the residence halls to consider the Meningococcal vaccination, as there is an increased risk of this highly contagious disease in this campus population. The Meningococcal vaccine (Menactra) is available at the University Health Services.

Persons claiming religious exemption to immunization requirements must sign a waiver form. There are NO religious exemptions to Tuberculosis clearance requirements.

The University Health Services offers the TB test as well as the MMR immunizations. The TB test is offered during normal clinic hours, except on Thursdays. The MMR immunizations are offered during normal clinic hours, Tuesdays-Fridays. For women of child-bearing age, the MMR vaccine is only given while on menses, on some form of birth control, or with a negative pregnancy test on the day of administration. No appointment is necessary.

Health clearance forms can also be faxed to: (808) 956-3583.


Information current as of 04.25.2013