New Student Health Forms
Due July 31, 2024
Welcome!
Dear Incoming Undergraduate and Graduate Students,
Welcome to Caltech! Student Health Services is here to assist you with the first step in your health journey at Caltech, which begins before you arrive on campus. All undergraduate, graduate, and visiting Summer students must submit the required immunizations and TB screening forms. Details and instructions are found on our webpage below.
Exceptions to this policy are granted for limited circumstances and are generally limited to medical exemptions or exceptional circumstances where tests/immunizations are unavailable at your current location. In all circumstances, exemptions require ADVANCED communication with Health Services. See below for helpful tips and contact information.
Student Wellness Services is here to assist you during your time at Caltech by providing healthcare, counseling, and occupational therapy services. Check out our website and visit us when you arrive on campus!
Sincerely,
Stephanie Long MD FAAFP
Medical Director
Student Health Services
After submitting a clearance item, the Details section will change from "No Data" to "Awaiting Review." You do not need to take further action at this point. Please allow up to 10 business days for the team to review your information and update your status. The Status column will remain "Non-Compliant" until a member of our health team verifies your information meets the health requirements. Our health team will communicate with you through the Student Health Portal if additional documentation is needed.
This screenshot demonstrates what the portal reflects once you've submitted your information successfully (The TB Blood Test has been submitted and is Awaiting Review).
Instructions
Please translate your records into English if your records are in another language.
Students enrolled in one of the above programs will not be able to access the Required Immunizations and Forms menu. Please follow the instructions you received via secure message on the Student Health Portal to upload your immunization records and TB screening questionnaire.
Immunization Requirements and Tuberculosis Screening
Please translate your records into English if your records are in another language.
If you are unable to obtain the required immunizations, tests for immunity, or tuberculosis (TB) testing at your current location, please make an appointment at Student Wellness Services within one week of your arrival on campus to have these items completed at your expense. Student Wellness Services does not bill insurance and does not submit insurance claims on your behalf.
Please upload all available required forms and acknowledge the compliance forms by July 31, 2024, even if you require additional testing or immunizations.
- Measles, Mumps, and Rubella (MMR): Two doses of measles, mumps, and rubella (MMR) vaccine with the first dose on or after 1st birthday OR blood test showing immunity (positive titers). If the first dose was received on or after the first birthday, then a measles, mumps, rubella booster will be required.
- Varicella (Chicken Pox): Two doses of varicella (chicken pox) vaccine on or after the first birthday OR blood test showing immunity (positive titer). If the first dose was received on or after the first birthday, then a varicella booster will be required. A personal history of having chickenpox does not meet compliance.
- Meningococcal Conjugate ACWY (Meningitis): One dose of meningococcal conjugate ACWY (meningitis) after age 16 for all students under age 22.
- Tetanus, Diphtheria, and Pertussis: One dose of Tdap is due after age 7 AND a booster dose of Tetanus and diphtheria OR Tdap is due every 10 years.
- Tuberculosis (TB): All students must complete the TB Risk Screen in the Student Portal. If further action is needed, the TB Blood Test compliance will appear in your portal. TB Blood tests will be accepted if they are the lab results for a T-spot or QuantiFERON gold completed in the prior six months. Older tests will not be accepted. If your TB blood test is positive, then you will be asked to have a Chest X-ray and have a provider complete your TB Medical Evaluation Form. The form will be made available to you in your portal. Chest X-rays should be completed in the prior 12 months.
View the vaccine exemption policy.
Effective June 19, 2023: COVID-19 vaccination no longer required.
We understand that for a small number of students, you may be unable to obtain the required immunizations, tests for immunity, or tuberculosis testing at your location due to the availability of vaccines or health services before you arrive on campus.
In this case, you must contact Student Wellness Services before you arrive and make an appointment at the Health Center within one week of your arrival on campus. We will help you create a plan to fulfill the requirements. While there is no charge for office visits at Student Wellness Services, vaccines and lab tests will incur charges by the lab or pharmacy supplying these services. Student Wellness Services does not bill insurance and does not submit insurance claims on your behalf.
Non-compliance or incomplete compliance with these requirements will result in a hold on your student account through the Office of the Registrar, and you will be unable to register for classes. Exceptions to this policy are granted for limited circumstances and are generally limited to medical exemptions or exceptional circumstances where tests/immunizations are unavailable at your current location. In all circumstances, exemptions require ADVANCED communication with Health Services.
If you have questions, login to the Student Health Portal, navigate to the Messages menu, and select "I want to send a message about my Health Forms" when prompted. You are responsible for reading and responding to any secure messages sent to you from the Health Services Staff.
If you plan to participate in intercollegiate athletics, you will be required to complete additional forms and a medical clearance process per NCAA bylaws. You should receive separate communication from your coach or the Caltech Athletics staff with steps to complete the items required to attend any team activities. Any questions can be directed to your coach, or Carly Horchler, Assistant Athletic Director, at carly@caltech.edu.
View the Pre-Participation Requirements.
If you are under 18, California state law requires Caltech's Student Wellness Services to contact your parents for most treatment at Student Wellness Services.
Generally, a person becomes an adult at age 18. Prior to reaching 18 years of age, parents or legal guardians have the right to make most health care decisions, including the right to consent to health care. This means that a parent or guardian must generally give consent for any students under the age of 18 when they are receiving services at Student Wellness Services.
In some situations, a person under 18 can get health care without parental or guardian consent, including for the following services if certain conditions are satisfied:
- Emergency Care for Life-threatening Health Concerns
- Family Planning and Contraceptive Services
- Sexually Transmitted Infections
- Mental Health Treatment and Counseling
- Pregnancy
- Drug and Alcohol-related Problems
- HIV/AIDS Treatment
- Sexual Assault Treatment
- Abortion
- COVID-19 Testing
- Situations involving public health reportable infectious disease care
- Suspected Child Abuse Victims
Some individuals under 18 have a special status in California, allowing them to seek care independently. These include emancipated minors and minors living with complete financial independence separate and apart from their parents.
Outside of the situations listed above, Student Wellness Services must contact your parents before we can provide any services.
Your parent or guardian must complete the Consent for Treatment of a Minor form before you can receive services unless you are receiving care for the specific situations listed above OR have a special status as defined by California law.
This consent form only applies to services at Caltech's Student Wellness Services and Emergency Services on Campus. If you receive care offsite, you must follow the policies and practices of the specific healthcare provider before receiving treatment for non-life-threatening emergencies.
Please contact Information Management Systems and Services (IMSS) for assistance with your Caltech access credentials.
Website: https://imss.caltech.edu/
Phone: (626) 395-3500
Email: help@caltech.edu
- The entrance health forms are due July 31st and are required for every incoming student.
- Student Wellness Services will make 3 attempts to reach you to assist in completing your health forms.
- It is your responsibility to check the Student Health Portal for any communications from our team.
- It is your responsibility to communicate any delays in completing your health forms to our team via the Student Health Portal.
- You will be dropped from your Fall classes or unable to register for classes if you do not complete the health forms.
Immunization Requirements and Tuberculosis Screening
Please translate your records into English if your records are in another language.
If you are unable to obtain the required immunizations, tests for immunity, or tuberculosis (TB) testing at your current location, please make an appointment at Student Wellness Services within one week of your arrival on campus to have these items completed at your expense. Student Wellness Services does not bill insurance and does not submit insurance claims on your behalf.
Please upload all available required forms and acknowledge the compliance forms by July 31, 2024, even if you require additional testing or immunizations.
- Measles, Mumps, and Rubella (MMR): Two doses of measles, mumps, and rubella (MMR) vaccine with the first dose on or after 1st birthday OR blood test showing immunity (positive titers). If the first dose was received on or after the first birthday, then a measles, mumps, rubella booster will be required.
- Varicella (Chicken Pox): Two doses of varicella (chicken pox) vaccine on or after the first birthday OR blood test showing immunity (positive titer). If the first dose was received on or after the first birthday, then a varicella booster will be required. A personal history of having chickenpox does not meet compliance.
- Meningococcal Conjugate ACWY (Meningitis): One dose of meningococcal conjugate ACWY (meningitis) after age 16 for all students under age 22.
- Tetanus, Diphtheria, and Pertussis: One dose of Tdap is due after age 7 AND a booster dose of Tetanus and diphtheria OR Tdap is due every 10 years.
- Tuberculosis (TB): All students must complete the TB Risk Screen in the Student Portal. If further action is needed, the TB Blood Test compliance will appear in your portal. TB Blood tests will be accepted if they are the lab results for a T-spot or QuantiFERON gold completed in the prior six months. Older tests will not be accepted. If your TB blood test is positive, then you will be asked to have a Chest X-ray and have a provider complete your TB Medical Evaluation Form. The form will be made available to you in your portal. Chest X-rays should be completed in the prior 12 months.
View the vaccine exemption policy.
Effective June 19, 2023: COVID-19 vaccination no longer required.
- Annual Influenza (Flu) for all students
- COVID-19 vaccination for all students
- Hepatitis A for all students
- Hepatitis B for all students
- Human Papillomavirus (HPV) for all students
- Poliovirus (Polio) for all students
- Haemophilus influenza for certain students
- Jynneos (M-Pox) vaccine for certain students
- Meningitis B for certain students
- Pneumococcal for certain students
- Zooster vaccination for age 50 years or older
Please discuss with a healthcare provider if you have questions.
Resource: CDC Recommended Adult Immunization Schedule for Ages 19 and Older
Instructions
Complete immunization and health history items
- Login to the Student Health Portal using your Caltech access credentials and navigate to the "Required Immunizations and Forms" menu.
- Use the "Update" button to add the requested information for each item required for clearance.
- Please translate your records into English if your records are in another language.
- Please check your email regularly for notifications from the Student Health Portal. This will be our main way of reaching you.
Submit a copy of your health insurance card
Note: Students considering enrolling in the Caltech Anthem Student Advantage (ASA) insurance plan DO NOT need to complete this step.
- Navigate to the "Insurance Card" menu.
- Make a copy or take a picture of both sides (front and back) of your health insurance card.
- Use the "Add New Card" button to enter your insurance card information and attach your pictures. Press "Save" when you are done.