Health Requirements

Personal Health History

The information provided on this form gives the staff of the health center an overview of your current health status as well as your past medical history. This information assists the heath center staff in providing the best possible health care to you.

View Personal Health History Form

Physical Exam

Like the personal health history form, a physical exam provides the health center with information regarding your current physical health status. This information provides a baseline for the health center staff to work from in meeting your health care needs. The physical exam also indicates that your physician has cleared you to participate in activity and physical education classes.

All students must have a TB test within one year of admission.

View Physical Exam Form

Immunization Records

Illinois State Law requires that all students taking 6 hours or more of classes provide information regarding immunization status. Currently students are required to provide documentation of:

• Measles: (Rubeola) Two doses are required. The first must be administered on or after the first birthday and the second must be administered no sooner than four weeks after the first.
• Mumps: One dose administered on or after the first birthday.
• Rubella: One dose administered on or after the first birthday.
• Tetanus/Diptheria (Td) booster within the last 10 years.

In lieu of these vaccinations, students may submit titre (blood test) results for measles, mumps, and rubella that indicate immunity to these diseases.

The following are available at Lang Health Center at minimal cost:

• Tetanus dipthoria (TD) $25
• Adacel Tdap   $40
• Hepatitis B   $50
• TB screening   $10
• 2-Step TB skin test $15
• MMR (measles, mumps, rubella) $50

Exemption Information

Students who are exempt from providing this immunization information include:

• Students born prior to January 1, 1957.
• Students who have medical documentation from a physician stating they may not receive a vaccination due to a medical condition.

View Immunization Form

Additional Requirements for Nursing Students

• Hepatitis B: a series of 3 injections given at 0, 1, and 5 month intervals respectively. Note: The hepatitis B series can be given on an accelerated schedule if necessary (0, 1, and 3 month interval). Please contact Lang Health Center for details and scheduling.
• Hepatitis B titre: a blood test that shows immunity to Hepatitis B.
• 2 step TB skin test: The first TB skin test is administered and then read 48-72 hours later. A second test is administered 1-3 weeks later following the same procedure. Once the nursing student has completed a 2-step TB skin test they must then receive a TB skin test annually thereafter.
• Varicella Verification form: this form documents immunity to chicken pox (varicella) by history of disease, a titre (blood test) showing immunity to the disease, or proof of 2 varicella vaccinations. This form can be obtained at Lang Health Center or through the nursing department.
• CPR card: nursing students are required to have current health care professional CPR/AED certification. A current copy of the card is to be on file at Lang Health Center.

For questions or additional information please contact your nursing advisor, the nursing department at 815.226.4152, or Lang Health Center at 815.226.4083.

Students enrolling at Rockford College are required to provide the following medical documentation, depending on student status:

* TB tests are available at Lang Health Center for $10.00 ea.

** Additional information required of athletes:

• NCAA Form
• Student Insurance Information Form
• Consent Forms
• Returning Student Health Update Form

Questions? Call Lang Health Center at 815.226.4083