Immunization records & health forms
Complete your forms and submit to Health Services by:
- Fax: 716.338.1461 or 716.376.7021
- In person at your campus health center
- Adobe Sign
Please do not submit by email.
MMR/meningitis form
In accordance with NYS public health law section 2165, any student born after Jan. 1, 1957, must provide proof of immunity against measles, mumps, and rubella.
Failure to provide proper documentation to JCC Health Services will result in an administrative withdrawal and a $25 fine.
Submit your MMR/Meningitis form to JCC Health Services if you are taking six or more credit hours or taking a HyFlex course. You may also mail, deliver in person, or fax to 716.338.1461 or 716.376.7021. Do not email your immunization or health records.
MMR records must include two MMR. Meningitis must be within the past three years or complete the declination section on the MMR/Meningitis form.
COVID-19 vaccination
JCC no longer requires COVID-19 vaccination. COVID-19 vaccination is recommended by NYS Department of Health and the CDC.
If you have received the COVID-19 vaccination, submit your records:
For more information, visit sunyjcc.edu/covid19.
Residence Life health history form
If you live in the residence halls on campus, you must also submit:
Nursing & OTA forms
JCC's Nursing and Occupational Therapy Assistant programs require additional immunizations:
- Varicella times two (Chicken pox or positive Titer)
- Hepatitis B: Clinical sites request that you educate yourself about Hepatitis B. You are at an increased risk in the clinical setting of exposure to Hepatitis B and other diseases. Get updated vaccination for Hepatitis B or sign the declination on your JCC health report form that you will receive through your program. Hepatitis is a series of three.
- TDAP (Current within eight years)
How to find your immunization records
- Check with family members if you have "baby books" or childhood health records
- High school transcripts or transcripts from other colleges
- Family doctor
- Military records