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This document serves as a checklist for students to complete their health requirements before the start of classes at the University of Massachusetts Worcester. It includes details about necessary
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How to fill out student health clearance form

How to fill out STUDENT HEALTH CLEARANCE FORM
01
Obtain the STUDENT HEALTH CLEARANCE FORM from your school or health office.
02
Provide your personal information, including your name, date of birth, and student ID.
03
Fill out the medical history section, disclosing any previous illnesses, surgeries, or allergies.
04
Complete the immunization record section, listing all required vaccinations and their dates.
05
Have a licensed healthcare provider review and sign the form, confirming your health status.
06
Submit the completed form to the designated school authority by the specified deadline.
Who needs STUDENT HEALTH CLEARANCE FORM?
01
All new students enrolling in a school for the first time.
02
Students participating in sports or physical activities.
03
Students returning to school after an extended illness or injury.
04
Students who are changing schools or districts.
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Bacterial Meningitis: Texas law (SB 1107) mandates that all entering UT students who will be 21 or younger on the first day of classes must receive the bacterial meningitis vaccine. Only a quadrivalent vaccine or pentavalent vaccine meets the requirement. Meningitis B vaccines do not meet the requirement.
What is an employee health clearance?
A medical clearance will specify whether or not the employee is medically fit to perform the essential job functions of their position. The medical clearance includes an evaluation for respiratory clearance as well.
What is a health clearance?
Typically, these medical clearances involve physicals measuring blood pressure, BMI and heart rate, as well as additional services such as hearing and vision tests, biometric screening, pulmonary function tests and x-ray or b-read to monitor employee health.
What does it mean to be medically cleared?
The term is often used by surgeons requesting a medical evaluation before performing surgery on a patient. In the context of surgery, a medical clearance is, essentially, considered to be an authorization from an evaluating clinician that a patient is cleared, or deemed healthy enough, for a proposed surgery.
What does health clearance mean?
Your medical clearance is a determination of your medical qualification to serve overseas. Worldwide Available (Class 1): Issued to applicants, employees and eligible family members who have no identifiable medical conditions that would limit assignment abroad.
What happens during a medical clearance?
In pre op clearance, a physical examination will be done, and blood tests, chest x-ray, and electrocardiogram (EKG). Other tests and examinations may be necessary based on the patient's preexisting or discovered health conditions.
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What is STUDENT HEALTH CLEARANCE FORM?
The STUDENT HEALTH CLEARANCE FORM is a document that certifies a student's health status and readiness to participate in school activities, ensuring they meet health requirements set by the educational institution.
Who is required to file STUDENT HEALTH CLEARANCE FORM?
Typically, all students entering a new educational institution, particularly at the beginning of a new school year or semester, are required to file the STUDENT HEALTH CLEARANCE FORM.
How to fill out STUDENT HEALTH CLEARANCE FORM?
To fill out the STUDENT HEALTH CLEARANCE FORM, students should provide personal information, health history, details of any immunizations, and a health professional's verification of their health status.
What is the purpose of STUDENT HEALTH CLEARANCE FORM?
The purpose of the STUDENT HEALTH CLEARANCE FORM is to ensure that students are in good health, to track their immunization records, and to prevent the spread of communicable diseases within the school environment.
What information must be reported on STUDENT HEALTH CLEARANCE FORM?
The STUDENT HEALTH CLEARANCE FORM must report the student's name, date of birth, medical history, immunization status, any existing health conditions, and a signature from a healthcare provider confirming the information.
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