Student Health Form

Vermont State Law requires that all students be immunized, unless exempt, prior to school entry. For detailed information about the law, vaccine requirements, forms and a frequently asked questions document, please visit the VT Health Department website.

Before entering JSC, all students must have received the following immunizations:
1) 1 dose of Tdap (tetanus, diphtheria, and pertussis) vaccine or dose of Td
(tetanus and diphtheria) vaccine within the past 10 years. (Tdap is preferred)
2) 2 doses of MMR (measles, mumps, and rubella) vaccine
3) 3 doses of Hepatitis B vaccine
4) 2 doses of chickenpox (varicella) vaccine or history of the disease DOCUMENTED ON YOUR HEALTH FORM BY YOUR HEALTH CARE PROVIDER in the immunization section.
5) 1 dose of meningococcal vaccine (required only for first- year students living in dormitories)


Students living on campus must submit the health form prior to getting a housing assignment.

All incoming students, therefore, must:

  • Download and print out the form. Click here to download the form.
  • Visit your health care provider to get the health form completed and signed.
  • Return the completed form to JSC. Please submit the form to:

Johnson State College

Health Center

337 College Hill

Johnson, VT 05656

Questions?

For questions related to compliance with the school immunization law or general vaccine questions, please call the Health Department Immunization Program at 1-800-464-4343 ext 7638 or (802) 863-7638.


You may also contact the Johnson State College Health Center for specific questions at (802) 635-1265.