Immunization Requirements

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

Please do not submit by email.

You will be in administrative withdrawal from JCC and charged a $25 fine if you don’t turn in your forms and records.

    COVID-19 vaccination status

    If you have received the COVID-19 vaccination, submit your records:

    For more information, visit

    MMR/meningitis form

    If you are taking six or more credit hours at Jamestown Community College, you must submit to Health Services:

    Residence Life health history form

    If you live in the residence halls on campus, you must also submit:

    Nursing & OTA forms

    Nursing and OTA programs require additional immunizations:

    • Varicella (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 at being exposed to Hepatitis B and other diseases. Get updated vaccination for Hepatitis B or sign the declination on your JCC health report form that you'll receive through your program.
    • Tetanus
    • TDAP