(Click on Health Form to print form)
Students are required to submit the University Health Form, including a completed medical/health record and current immunization information. This applies to all new or continuing full- and part-time undergraduate and graduate students enrolled in a program of study leading to an academic degree at any public or independent institution of higher education in New Jersey. Documentation of immunizations must be received by August 1 for the fall semester and January 2 for the spring semester. The following documents are acceptable as evidence of a student's immunization history provided it includes the type of immunization and the date when each immunization was administered. This documentation will be accepted in the following formats:
- The University Health Form completed, signed and stamped by one's personal health care provider
- Documentation on the health care provider's letterhead, official school immunization record, or record from any public health department
- A record or an official college affidavit form signed by a health care provider licensed to practice medicine in the United States or in any foreign country
MMR (measles, mumps, rubella):
The William Paterson University mandates that any student born after 1956 must provide documentation of two (2) doses of the MMR vaccine. The first dose must be administered on or after your first birthday and the second dose must not be administered any less than one (1) month from the first.
Hepatitis B- Completed series:
As of the Fall 2008 semester, New Jersey law requires all new incoming students provide proof of a completed Hepatitis B vaccine series.
*** Laboratory blood tests that demonstrate immunity for measles, mumps, rubella and hepatitis B may be submitted in place of vaccination documentation. We must receive a copy of the blood work results in order to verify immunity***
As of the Fall 2004 semester, New Jersey State law requires all students who intend to live in the residence life halls on campus (regardless of age) must provide documented proof of one (1) dose of the meningitis vaccine. Housing room assignments will not be given until proof of meningitis immunization is provided. It is recommended that if your meningitis vaccine is older than 5 years that you should have a booster. Meningitis Vaccines older than 5 years may not give you full immunity.
The tetanus vaccine, as well as a tuberculosis skin test, is highly recommended for University students.
A request for exemption from these requirements due to religious beliefs may be submitted to the Health and Wellness Center. The request must be in writing from the enrolled student if aged 18 or over and specifically state the religious doctrine that prohibits vaccination.
Exemption from requirements based on medical reasons must be submitted to the Health and Wellness Center in the form of a written statement from a healthcare provider indicating a specific immunization is contraindicated due to a valid medical condition. This documentation will be reviewed annually.
Please note- a student with religious or medical exemptions from receiving immunizing agents may be temporarily excluded from classes and from participating in institution sponsored activities during a vaccine-preventable disease outbreak or threatened outbreak. This decision shall be made by the institution in consultation with the Commissioner, Department of Health and Senior Services or his or her designee. This exclusion shall continue until the outbreak is over or until proof of the student's immunization or immunity is furnished.
Documentation must be received by August 1 for the fall semester and January 2for the spring semester.
Students who do not comply will have a registration hold placed on their account until documentation is received.
Please send all immunization records or letters of exemption and the University Health Form to:
William Paterson University
Counseling, Health and Wellness Center
Wayne, New Jersey, 07470
(973)-720-2360 (973)-720-2257 FAX: (973)-720-2632
Any questions, please call 973-720-2360