Submit Health Clearance Form

Information on obtaining the Health Clearance Form is given to students along with their acceptance packet. If you did not receive the Health Clearance Form, you may download it under our Forms page.

If you do not have a physician, this may be completed here at the Student Health Center.

You may not register for classes until you have received health clearance.

Comply with State of Hawai'i tuberculosis clearance guidelines

ALL students enrolled at Leeward Community College must have tuberculosis (TB) clearance. A TB Risk Assessment Form must be completed and signed by a U.S. licensed healthcare provider (M.D., D.O., A.P.R.N., or P.A.) within one year prior to your enrollment.

If your TB Risk Assessment is positive, a TB skin test or blood test, and possibly a chest x-ray are required. A negative TB skin test (PPD - Mantoux) or blood test (QFT, T-Spot) 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 your TB skin test or blood test is positive, a chest x-ray is required. TB tests must be performed by a U.S. licensed provider.

Returning or Transferring Students from a post-secondary school in Hawai'i (i.e., UH Manoa, UH Hilo, UH West Oahu, Other Community Colleges, Chaminade, HPU, etc.)

  • When you re-enroll in another post-secondary school in Hawai'i, a copy of your original certificate shall meet the Tuberculosis requirements for certification.
  • The Tuberculosis certificate must be done in Hawai'i for a post-secondary school.

Provide documentation of immunity to measles, mumps, and rubella (MMR)

  • Two doses of the live 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

The Hawai’i Department of Health has proposed adding additional required immunizations. Although not currently required for enrollment, these additional vaccines are: a) Meningococcal, b) Tetanus/Diphtheria/Pertussis (Tdap), and c) Varicella. The Meningococcal vaccine is STRONGLY RECOMMENDED for college students, especially students who intend to live in the campus residence halls, as there is an increased risk of this highly contagious disease in this campus population. The serogroup B Meningococcal (MenB) vaccination should also be considered; please discuss with your health care provider.

Other vaccines highly recommended include: a) Polio, b) Human Papilloma Virus, c) Hepatitis A and d) Hepatitis B. All vaccines are available at the University Health Services Mānoa.

Persons claiming religious exemption to immunization requirements must sign a Religious Exemption Waiver Form (PDF) . There are NO religious exemptions to Tuberculosis clearance requirements.

The Leeward Community College Student Health Center 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 be faxed to: (808) 455-0267, mailed, or sent via a secure email using FileDrop (see procedures below):

Leeward CC Student Health Center
96-045 Ala 'Ike Street, DH-A104
Pearl City, HI 96782


FileDropping (Securely emailing) Your Medical Records:
In order to send us your health records, you will need to have web access and have your health information stored on the device that you're using (computer, phone, tablet, etc).

  1. From any web browser, go to
  2. Click on the green box on the right side of the screen asking you to login.
  3. Click the Login Here link, and login using your UH username and password.
  4. After you've logged in, you will be redirected to a page that allows you to input a recipient.
  5. In the recipient field, type: You will need to retype this in the Confirm Recipient field.
  6. Check the box for Require Authentication.
  7. It is optional, but you may include what it is that you're sending in the Comment field, such as "Insurance Card" or "Health Clearance".
  8. After you've filled out both Recipient fields, click Proceed.
  9. Click the Choose File button to browse for your medical records. (You may input a description in regards to each file, but it is not necessary)
  10. Click the Start Upload button.
  11. You will be redirected to a confirmation page with the link to your uploaded file. You're finished!