Health Information and Forms

Required Health Information Form

All new, incoming students must complete and return the Health Information Form (PDF)  to Student Health Services by the due date listed below.

Fall Semester entrance: Due by July 15
Spring Semester entrance: Due by January 15
DPT Summer entrance: Due by June 1

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 (

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)

References for Health Requirements

American College Health Association Immunization Recommendations

Recommendations for Institutional Prematriculation Immunizations (RIPI)

Advisory Committee on Immunization Practices (ACIP)

Tuberculosis Screening Guidelines