Medical Forms

Health Form:

Immunization Record and Medical Information Form

To assist the college in providing appropriate care, all undergraduate students are required to submit a completed six-page health form as provided by the college admissions office at the time of admission. We understand that primary care offices are limiting appointments during this time of physical distancing. PLEASE go ahead and call now to schedule for an early summer appointment with your provider so you can have the medical form completed. Varsity athletes, outdoor adventure team, rugby, and cheer&dance affinity program participants must complete additional paperwork online at

For any incomplete items on submitted forms, you will be contacted through your Emory & Henry College EMAIL address.

*For School of Health Sciences graduate requirements see individual program information*

Minimum Required Immunizations or Proof by Titer:

  • MMR (Measles/Mumps/Rubella)
  • Polio
  • Tetanus-Diptheria (Td or Tdap) Booster must be within past 10 years

Commonwealth of Virginia Certificate of Religious Exemption Form must be completed and notarized if you have not received required immunizations

Strongly Recommended Immunizations:

  • Coronavirus
  • Current year Influenza
  • Hepatitis A and B
  • Meningococcal (Quadrivalent and B)
  • Varicella
  • HPV (Human Papillomavirus)