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Pre-Entrance Health Form

Prior to your enrollment we need information about your health status. Some information is needed to meet requirements of Virginia law (immunizations), to meet University requirements (health insurance), and to assist us in caring for you if you need health services.

The Pre-entrance Health Record (PDF form) can be printed from this website (see below) or you may call 434-924-1525 to receive a form by mail.

It is important that you complete the Pre-entrance Health Record accurately and return it by August 31 for fall semester (January 31 for spring semester). If your form is not postmarked by August 31 (January 31 for spring semester), you will be subject to a late fee of $100.

Once data from the form has been entered, Student Health offers a secure website (https://www.healthyhoos.virginia.edu) where you may view immunization data in case you are contacted about any deficiencies.

Pre-Entrance Health Forms (2013-2014)
Medical and Nursing Students Only All Other Students

If you have any questions, contact Medical Records.