Mandatory Health Form

Print the Mandatory Health Form (English Version) or Mandatory Health Form (Chinese Version) and have your healthcare provider fill in the dates when you received the required immunizations.

You can deliver your forms to us by hand, by mail, or by fax (please include your GWID) at:

Student Health Service
Attn: Immunization Record
2141 K Street, NW Suite 501
Washington, DC 20037
Fax: 202-973-8220
Alternate Fax: 202-973-1572

Your healthcare provider can also send the completed form to us directly.

Please retain a copy of the completed form for your records. It is each student’s responsibility to ensure that their healthcare provider completes the form and that it is returned to Student Health by the deadline.

If for some reason you are unable to complete the immunization requirements before arriving on campus, the Student Health Service can assist you in meeting these requirements. Please bring your available immunization records and the Mandatory Health Form (English Version) or Mandatory Health Form (Chinese Version) when you visit.

Please note: Medical, Physician Assistant (PA), Clinical Lab Science, Physical Therapy, Nursing, and Sonography students must comply with program requirements in addtion to DC Immunization law requirements.