Health Status Assessment (Page 2 of 3) in pdf

Immunization Guidelines for the Required Immunizations

Please provide documentation (day/month/year) of vaccines and/or antibody titers on the

Health Status Assessment form.

Hepatitis B Proof of either:



A complete three-injection series of hepatitis B vaccinations



A serum titer confirming immunity

Note: The hepatitis B injection series is a 4-6 month process. There must be a minimum of four weeks between the 1

and 2

immunization, minimum of eight weeks between the 2

and 3

immunization, and a minimum of sixteen weeks

between the 1

and 3

immunization.

Measles (Rubeola), Mumps, Rubella (MMR) Proof of either:



2 MMR’s, 1 month apart with the 1

dose after the first birthday, and the 2

dose at least 1 month thereafter



Serum titer confirming immunity

Note: ALL students are required to show proof of rubella.

Tetanus – Diptheria – Pertussis (Tdap)

Proof of a tetanus–diphtheria-pertussis vaccination within the last 10 years from the start of the clinical training.

Varicella (Chicken pox) Proof of either:



Documentation of 2 doses of varicella vaccine 4 weeks apart, or



A serum titer confirming immunity

Note: The varicella injection series is a four-week process.

Note: If first dose of varicella was received prior to thirteen years of age only one dose necessary.

Proof of date of birth must be included.

Influenza



Medical documentation of annual immunization



If student identifies a “medical Exemption”, documented validation by primary care provider required



If student identifies a “religious exemption”, documented validation by clergy required

TB Skin Test



A 2-step skin test with negative results within 3 months of initial clinical start for students who have never had a

skin test done



A skin test with negative results within 3 months of clinical start for students with documented history of previous

skin tests



Quantiferon TB test acceptable in lieu of annual TB skin test



Negative chest x-ray post TB skin test conversion, with annual symptom survey



Documented validation of negative chest x-ray dated post positive TB skin test conversion



If a student is positive for active TB disease, they must participate in an active treatment plan



Student not eligible to participate in clinical practicum until such time as medical provider determines that they are

not communicable

Drug Screen - A 10 panel drug screen is required.



A negative result will require no further screens unless indications of impairment are present



A positive result will require additional testing under the supervision of a Medical Review Officer

Norris Health Center provides a 10 panel drug screen which includes: alcohol, amphetamines (includes methamphetamine),

barbiturates, benzodiazepines, cocaine, cannabinoids, methadone, opiates, oxycodone, suboxone. The cost is $30.

Other area locations that perform 10 panel drug screens include:

Assurance:

Any Lab Test Now:

Concentra:

Health Status Assessment Page 2

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