Information needed for the Health Center
From Incoming Students
Dear Incoming Student and Parent,
Prior to the first day of classes we need you to complete certain Health Certification forms in order to comply with New York State law, protect your health and that of your fellow students, and have a basis for understanding and serving your health needs while you are here. Here is a check list to assist you in the required documents that must be received by our office in order to begin classes at SUNY Fredonia.
1) _____ Please Complete the Health History Form that has been mailed to you. Although not required, all students are encouraged to have a baseline physical done by their primary care physician or pediatrician prior to coming to SUNY Fredonia. If this physical has been done, please send a copy along with these health forms.
If you have not received this form, you can print it out using the following:
2) ______ Please mail or fax a copy of your Immunization Record . This record MUST include proof of protection against measles, mumps and rubella .
3) ______ Please fill out the Tuberculosis (TB) Screening Questionaire. If the PPD is positive, a chest x-ray is required. Please include a copy of the chest x-ray report. If you have not received this form, you can print it out using the following:
4) ______ Please complete the Meningitis Survey found on "Your Connections". Access to “Your Connections” can be found on the lower right of the Fredonia home page (www.fredonia.edu)
5) ______ If you are an Incoming Athlete, you will need to have a physical examination completed by your primary care physician. Once completed the form needs to be mailed or faxed to our office prior to participating in the sport. The Athletic Physical form can be printed out by using the following link:
6) ______ If you are under the age of 18 years upon beginning here at SUNY Fredonia, you will need to complete the Consent for Medical Care for Minors form . The Consent for Medical Care for Minors form can be printed out using the following link.
Thank you in advance for your cooperation in completing this health history information. If you have any questions while completing these forms, please contact the LoGrasso Hall Health Center at (716) 673-3131.
All materials should be mailed/faxed to the LoGrasso Hall Health Center at:
LoGrasso Hall Health Center
Fredonia, NY 14063
Faxed to : (716) 673-4722