Health Forms & Requirements

Health Forms and Requirements

Please review Hamel Health Center’s student health forms. 

Health Forms for Fall 2024 Students

Due: June 1, 2024
For: New Undergraduate, Graduate, International students and part time Health Sciences majors

Undergraduate Student Requirements
  1. TB Questionnaire (available on Patient Portal)
  2. Health History Form (available on Patient Portal)
  3. Immunization Form (download Immunization Record Form, have your healthcare provider fill it in and upload it to the Patient Portal)
  4. Most Recent Physical (submit a copy via Patient Portal)
Graduate Student Requirements
  1. TB Questionnaire (available on Patient Portal)
  2. Immunization Form (download Immunization Record Form, have your healthcare provider fill it in and upload it to the Patient Portal)
Form Assistance

If you need assistance filling in any of our forms, please contact us at 978-837-5441
or hamelhealthcenter@merrimack.edu.

COVID-19
The COVID-19 vaccine and booster for which an individual may be eligible are highly recommended for students, faculty and staff. However, Merrimack College does not require proof of COVID vaccination for enrollment, employment or to be a guest on our campus.