Required Medical Records for Incoming Freshmen and Transfer Students

Student Health Services requires all students to submit the Medical History Form, Preventative Health Care Examination Form and an Immunization Record prior to attending Kentucky State University.

Documentation from a doctor or clinic regarding the following:

• Preventive health care examination completed by doctor or clinic (No older than twelve (12) months)

• Tuberculin Skin Test within the past six months (International Students Only)

• Copy of chest X-ray for history of positive tuberculin test

Required complete immunizations include:

• Polio Series (x4)

• Adult Tdap (not older than 10 years)

• Meningitis Vaccine (up to age 26) – Meningococcal Quadrivalent (A, C, Y, W-135)

• Mumps (MMR x 2 or documentation of disease)

• Varicella Vaccine x 2 or History of Chickenpox

• Hepatitis B Series x 3

  Note:  Documentation of disease should be verified or signed on physician’s/clinic’s letterhead.

  Note: Documentation from Physician and Parent – NO Immunizations because of religion

Recommended immunizations include: 

 

 

 

 

 

• Hepatitis A Vaccine

• HPV Vaccine

• Pneumococcal Vaccine