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/campus_life/wellness/health/

Required Health Forms

Health History and Pre-Matriculation Certificate of Immunizations

Widener University’s Pre-Matriculation Immunization Policy requires all incoming Freshmen, International, Transfer, and Graduate (PT, & PSY.D.) students to provide Student Health Services with the following health and immunization information. A healthcare provider’s signature is only required when filing for a medical exemption. Failure to comply with this process will jeopardize a student’s standing with the university.

Required Immunizations

Immunization records must be attached.

  • Tetanus/Diphtheria/Pertussis (Tdap) Booster — Must be within the last 10 years
  • Measles, Mumps and Rubella (MMR)Two documentation options: Two dates of MMR vaccination or laboratory evidence of immunity (must submit titer result).
  • Varicella (Chicken Pox)Two documentation options: Two dates of Varicella vaccination or laboratory evidence of immunity (must submit titer result).
  • Meningitis — Vaccine is required for undergraduate students under the age of 23 years old. Administration must be within the past 5 years. Two dates of Meningitis vaccination required.
  • Hepatitis BTwo documentation options: Three dates of Hepatitis B vaccination or laboratory evidence of immunity (must submit titer result).
  • Tuberculosis Screening— Must be within 1 year of your arrival at Widener University, regardless of BCG Inoculation. Three documentation options: PPD (Purified Protein Derivative), Quantiferon TB Gold (must submit titer result), or T-Spot/Interferon gamma release assay (IGRA) (must submit titer result).

All required and suggested vaccines are available and administered at Student Health Services.

Related Forms

NCAA/Club Sports

For participation in NCAA sports, please visit the Widener Pride Staff Directory website and contact the coaches directly for information.

For participation in Club sports please contact the Pride Recreation Center directly at priderecreation@widener.edu or call 610-499-1323.

Release of Records

Medical records are released only with the completion of a Widener University Health Services Release of Information Form. Requests for copies of medical records require a 48-hour waiting period.