Health Information and Forms
Required Health Information Form
All new, incoming students must complete and return the Health Information Form to Student Health Services two weeks before their scheduled orientation date.
Compliance with and completion of this form is a Commonwealth of Virginia and Lynchburg College requirement for all full-time students.
Women's/Men's/Sexual Health Forms
These forms are only required if you make a GYN or men's health appointment.
Medical Release Form
Current LC students who need records to be sent to or received from other medical offices may fill out the medical release form and return it to Student Health Services by fax (434.544.8185) or email (firstname.lastname@example.org).
Required Immunizations and Screenings
- Tetanus and Diphtheria Vaccine (Td or DPT): Must have a completed series with a booster of Tetanus/Diphtheria/Pertussis (TdaP) within the last 10 years
- Hepatitis B Vaccine: Must receive three (3) doses OR provide titer report indicating positive immunity.
- Two (2) MMR Vaccines (Measles, Mumps, and Rubella):
- administered after your first birthday AND after 1957,
- OR two (2) measles vaccines, one (1) rubella, one (1) mumps vaccine.
- All must have been administered after your first birthday AND after 1957,
- OR titer report indicating MMR immunity is acceptable in place of vaccine documentation.
- Meningococcal Vaccines: One vaccine is required on or after the 16th birthday
- Two Varicella Vaccines OR positive blood test showing immunity
- Tuberculosis Screening:
- Must have risk assessment screening and, if positive screening, Tuberculin skin test x 2
- Chest x-ray required if test results are positive
- Sickle Cell Screening (Hgb S)
Health Science Clinical Internships
Clinical Clearance Form to be completed upon request by the clinical director of your program.