Health Records & Forms
Texas Southern University follows the guidelines of the Center for Disease and Prevention (CDC) and the American College Health Association (ACHA) which recommends that college students be current with all immunizations. Beginning January 1, 2012, all newly admitted students and any student returning to the university following a break in enrollment of at least one fall or spring semester, under the age of 22, will be required to have the meningitis vaccination or an approved exemption prior to attending classes. To meet the immunization requirement, the student must provide evidence of an initial bacterial meningitis vaccination or booster during the five-year period preceding and at least 10 days prior to the first day of classes. Students are also encouraged to consult with a physician about the need for the immunization against bacterial meningitis to prevent the disease. A student is NOT required to submit evidence of vaccination against bacterial meningitis if:
- the students is 22 years of age or older (by the first day of classes)
- the student is enrolled only in online or other distance education courses
- the student is enrolled in a continuing education course or program that is less than 360 contact hours, or continuing education corporate training
- the student is enrolled in a dual credit course which is taught at a public or private K-12 facility not located in a higher education institution campus
ALL STUDENTS WHO PLAN TO LIVE IN CAMPUS HOUSING, REGARDLESS OF YOUR AGE, WILL BE REQUIRED TO SUBMIT PROOF OF VACCINATION AGAINST BACTERIAL MENINGITIS TO HEALTH SERVICES 10 DAYS PRIOR TO MOVE IN. IN ORDER TO BE CLEARED THROUGH HEALTH SERVICES, YOUR SHOT HAS TO BE ADMINISTERED WITHIN THE LAST 5 YEARS.
Submitting Health Records
All health records must have the signature or stamp of a physician or his/her designee, or public health personnel on a form which shows the month, day, and year the vaccination or booster was administered. Other acceptable forms of proof of vaccination include an official immunization record generated from a state or local health authority or an official record received from school officials, including a record from another state.
Choose from the following options to submit a copy of your health and immunization record(s), write your name, TSU Student ID, and date of birth on each page you submit:
Scan and email your documentation to email@example.com
Texas Southern University,
Student Health Center,
3100 Cleburne Street,
Houston, Texas 77004
To the Student Health Center (Located on Tierwester, Behind Lanier East)
Must provide a certified English translation for all health and immunization records
Exemptions to Immunization Requirements:
Chapter §97.62of the Texas Administrative Code (TAC) describes the conditions under which individuals can seek exemptions from Texas immunization requirements. Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States.
A student or a parent or guardian of a student, is not required to submit evidence of receiving the vaccination against bacterial meningitis if the student, or a parent or guardian of a student submits to the institution:
- An affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine in the United States, in which it is stated that, in the physician’s opinion, the vaccination required would be injurious to the health and well-being of the student. The certificate must contain a date and will expire after one year, unless a lifelong condition is specified.
- OR a notarized affidavit signed by the student stating that the student understands the risks and benefits of vaccination(s) and declines the vaccination(s) for reasons of conscience, including a religious belief. Students seeking an exemption for reasons of conscience must use a form provided by the Texas Department of State Health Services.
Students must request the form electronically from the Texas Department of State Health Services. It may take up to two weeks to receive the form. Once completed and notarized, the origin affidavit is submitted to Texas Southern University’s Student Health Services department, copies will not be accepted. Information about requesting the affidavit form is available at: http://www.dshs.state.tx.us/immunize/school/default.shtm#exclusions. Exemptions for reasons of conscience are valid for two years.