Student Health Records
This office collects and reports on immunization records in compliance with New York State Public Health Law.
Students may download both health forms below:
New York State Public Health Law 2165 requires that all college students born on or after January 1, 1957, and taking more than (6) credit hours, provide proof of immunity to measles, mumps, and rubella. Proof of immunity may be accomplished by providing official documentation of (2) measles vaccines; (1) mumps vaccine, and (1) rubella vaccine; or (2) MMR vaccines; or serologic proof of immunity.
Villa Maria College strongly recommends the meningitis vaccine, especially for those students who will be residing at Collegiate Village.
New York State Public Health Law also requires colleges to distribute information about meningitis and vaccination to all students enrolled for at least (6) credit hours. The meningitis response form must be completed and returned to the Health Center indicating proof of vaccination or declination of the meningitis vaccine.
Failure to comply with immunization law will result in disciplinary action including a hold placed on the student’s account, prohibiting class attendance, withholding grades and transcripts, and the inability to register for future semesters.
Questions regarding the Public Health Laws and vaccination requirements should be directed to the registered nurse in the Health Center. A self-completed health report is requested of all students. The report is kept in confidentiality in the Health Center. The report can be found in the information packet sent with the acceptance letter from the Admission Department.
Students in the Physical Therapist Assistant program require a more comprehensive report. That form will also be included in the admissions packet for the appropriate students.
According to Immunize.org, Meningococcal disease is a serious illness caused by a type of bacteria called Neisseria meningitidis. It can lead to meningitis (infection of the lining of the brain and spinal cord) and infections of the blood. Meningococcal disease often occurs without warning— even among people who are otherwise healthy. Meningococcal disease can spread from person to person through close contact (coughing or kissing) or lengthy contact, especially among people living in the same household.
There are at least 12 types of N. meningitidis, called “serogroups.” Serogroups A, B, C, W, and Y cause most meningococcal disease. Anyone can get meningococcal disease but certain people are at increased risk, including:
- Infants younger than one year old
- Adolescents and young adults 16 through 23 years old
- People with certain medical conditions that affect the immune system
- Microbiologists who routinely work with isolates of N. meningitidis
- People at risk because of an outbreak in their community
Even when it is treated, meningococcal disease kills 10 to 15 infected people out of 100. And of those who survive, about 10 to 20 out of every 100 will suffer disabilities such as hearing loss, brain damage, kidney damage, amputations, nervous system problems, or severe scars from skin grafts.
Meningococcal ACWY vaccine can help prevent meningococcal disease caused by serogroups A, C, W, and Y. A different meningococcal vaccine is available to help protect against serogroup B. For more information, visit immunize.org/vis/meningococcal_acwy.pdf.
Health Law requires that all college and university students enrolled for at least six (6) semester hours or the equivalent per semester, or at least four (4) semester hours per quarter, complete the following form that will be sent to the Villa Maria College Student Success Center.
If you have not received the Meningococcal vaccine within the last 5 years, and you agree with the statement below, click the button below to complete the form on the page.
I have read, or have had explained to me, the information regarding Meningococcal disease. I understand the risks of not receiving the vaccine. I have decided that I (my child) will not obtain immunization against Meningococcal disease.
Health Records Request Form
Villa Maria College can provide former students information that was submitted to the College concerning health an disability records. Information is collected upon enrollment in the College and kept digitally indefinitely. To request the information on file, students must complete the Health Records Request Form, which can be access by clicking the button below.