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Updated: January 2016

Admission Information

Immunization and Medical History Forms (Required)

Instructions for completion of required forms:

  1. Read the Form Completion Instructions carefully.
  2. Download and print Immunization History and Medical History Forms (requires Adobe Reader).
  3. International Students: Also print and complete the TB Screening Form.
  4. Ensure that forms are submitted by the deadlines specified below.
  5. Under 18 years old? Parent/Guardian must complete and submit the Authorization and Consent for Treatment of Minors form.

Optional Disclosure of Private Mental Health Information*

  • * In compliance with the Student Optional Disclosure of Private Mental Health Act, the university has established procedures for students to have the opportunity to authorize, in writing, the disclosure of certain private mental health information to a designated person. Access to this information will be provided only to qualified examiners. To make such a disclose please click on the above link.

Deadlines for forms submission:

  • Forms must be submitted by July 1st, for Fall, December 1st for Spring and April 1st, for Summer semesters.


Why do I need to submit these forms?

The Illinois College Immunization Code requires that college students be immunized against tetanus, diphtheria, measles, mumps, and rubella. Proof of immunity must be signed/certified by a health care provider or public health official. International students are required to undergo tuberculosis screening when they arrive on campus.

What are the vaccination and tuberculosis requirements:

Illinois requires all college students to be immunized against certain vaccine-preventable diseases. These include:

 Measles - Two vaccinations required, on or after the first birthday. Must be live vaccine, which was available after 1967
 Mumps - One vaccine
 Rubella - One vaccine
 Tetanus/diphtheria US Citizens and Permanent Residents: booster within 10 years of the first day of the start of classes. International Students: documentation of at least three tetanus and diphtheria vaccinations, the third given within 10 years of the first day of the start of classes.

You can receive any or all of the required immunizations at McKinley for a charge.

Are there fees for TB screening and immunizations I may be required to receive?

TB Screening consists of completion of a paper questionnaire and a Quantiferon TB Gold blood test. There is a charge for the blood test. You can receive any or all of the required immunizations at McKinley for a charge.

How can I submit my forms and records?

You can fax, mail or drop-off your documents. You can fax to 1-217-244-1278. Documents can be received by fax 24 hours a day. You can mail documents to: McKinley Health Center, Attn:
    McKinley MIS
    1109 S. Lincoln Ave.
    Urbana, IL 61801
We are not able to accept documents by email. Please include your University Identification Number (UIN) on each document.

Is a physician signature required?

A doctors signature is not required if you send us official immunization records. If you are sending unofficial records, a health care professionalís signature is required.

How do I complete TB Screening requirements?

Only international students are required to complete the TB screening form. Upon arrival to campus, international students must visit the ISSS office and get their I-Cards prior to coming to McKinley to initiate their TB screening. Do not complete a TB screening or chest x-ray in your home country.

Is a physical exam required?

No, a physical exam is not required for admission. The medical background provided by the student on the Medical History form is sufficient.

I have to submit my forms late, what will happen?

There is not an immediate penalty for submitting the forms after the deadline; however, it is very important to submit them as soon as possible. Students who do not submit by the deadline will receive email notificationthat failure to comply by a designated date will not be able to add or drop classes during the current semester and register for classes during subsequent semesters.

Will I be notified that my documents were received?

Yes. You will receive an email notification to confirm receipt of your documents/compliance with State immunization requirements. If your records are incomplete, you will receive an email informing you of any missing immunization requirements.

Are there any exemptions to the requirements?

  • Medical exemption - A written, signed and dated statement from a physician stating the specific contraindicated vaccine(s), the reason why and duration of the medical exemption is required.
  • Pregnancy or suspected pregnancy - A signed and dated statement from a physician indicating that you are pregnant (include expected date of delivery) is required. After delivery, you must then comply with State Immunization requirements as directed by your physician.
  • Religious exemption - Contact the Office of the Dean of Students at (217) 333-0050.

What health care services can I receive as a student at the University of Illinois?

Learn more about services offered at McKinley Health Center


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