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Mandatory Immunizations and Medical Report Form due June 9, 2020
Students are required to submit a confidential health history and to document proof of immunizations which are required by Connecticut state law. For undergraduate students, the Student Health Center strongly recommends a pre-college physical exam. However, the Student Health Center is requesting all students submit their health history and proof of immunizations (documented on the Student Medical Report Form) by June 9, 2020 (for Fall semester entry). Students may mail in their physical exam documentation at a later date if necessary.

How to complete:

  • Go to the website:
  • Carefully review the list of required immunizations (Connecticut state requirements may be different than requirements in your home state).
  • Download and print out the appropriate form (i.e., Undergraduate or Graduate Student Medical Report Form).
  • Students should complete the health history part and the tuberculosis screening questions (Part I).
  • Present this form to your health care provider. Ask your health care provider to document your immunization history on this form. Additionally, your health care provider needs to review your tuberculosis screening questions. Students at high risk for tuberculosis will need to be tested (as outlined in the form).
  • Mail, fax or upload your form to the Student Health Center (go to for more information on returning your form).

Fairfield University Student Health Insurance Requirement

Fairfield University requires that all full-time domestic undergraduate students maintain or purchase a health insurance policy. Fairfield University requires all full-time undergraduate and graduate international students to purchase the University sponsored health insurance policy. To learn more about this requirement go to: Health Insurance

The deadline for domestic students to submit the on-line waiver to decline the Fairfield University sponsored student health insurance is Thursday, August 6, 2020.

Students with private health insurance should become familiar with their plan prior to coming to college. For example, students should check with their insurance provider regarding which labs are acceptable to use for blood tests, cultures, etc. Students should also inquire if “referrals” from their Primary Care Provider are required by their insurance plan for medical specialist visits. Families may need to request an additional insurance card for their college student. Students will need to carry their own health insurance card at college.

The Student Health Center’s default laboratory for blood tests, cultures, etc. is Quest Diagnostics. Students may go to to view Quest Diagnostics’ list of acceptable insurance providers and third party payors.

Students with Complex or Chronic Medical Conditions
Students with complex or chronic medical conditions and/or disabilities which need additional attention may contact the Director of the Student Health Center, Julia Duffy APRN, at ext. 2241 prior to coming to campus to discuss any special medical needs. They should also contact the office of Disability Support Services at ext. 2615.

Students with Attention Deficit Disorder
The Health Center does not prescribe medications for Attention Deficit Disorder. Students should make arrangements with their prescriber at home to assure uninterrupted access to their medication. Please secure Attention Deficit Disorder medications in a locked box.

Students with Food Allergies
For information regarding supplemental forms and resources for students with food allergies please go to

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