First Year Student Health Record Information

Medical History and Immunization Requirements

DePauw University requires that all students have on file a completed Student Health
Record 1st Year Student Physical Form with DePauw University Student Health Services by August 1st. The
Student Health Record includes a physical examination certificate and immunization
record. Failure to submit the completed Student Health Record prior to the start of
classes of the first term of enrollment may result in cancellation of the student's classes.

Both required and recommended immunizations are specified in the Student Health
Record. Proof of immunization may be provided through the following options:
completion of the Student Health Record by the student's physician; a physician's
certificate; immunization records forwarded by another school; OR a record maintained
by the student or parent showing the month and year during which each dose of vaccine
was administered.

Requests for exemption from the above immunization requirements for other than
medical reasons may be recognized by DePauw based on religious grounds only.
Requests for exemption must be made in writing, in advance of the start of classes and
signed by the student if at least 18 years of age. Requests for exemption from
immunization requirements based on medical grounds must be accompanied by a written
statement from the student's healthcare provider indicating the nature and duration of the
medical condition which contraindicates an immunization, along with the specific
vaccine identified as detrimental to the student's health, certifying pregnancy or suspected
pregnancy, or verifying that the student is currently completing the course of all required
immunizations. Medical exemptions expire when the medical condition(s)
contraindicating immunization change in a manner which permits immunization. All
requests for exemption will be reviewed and decided by the Medical Director of DePauw
University Student Health Services. The review is final and not subject to any appeal. A
signed waiver form will be kept on file at DePauw Health Services. Immunization Waiver Form

Students holding exemptions may be excluded from campus activities or instructed to
leave campus, for their protection, in the event of an outbreak on or near campus of any
of the vaccine -preventable diseases, until the outbreak is over.

Further information regarding immunization requirements or exemptions may be
obtained by contacting DePauw University Student Health Services.