Center for Health and Wellness

Required Immunizations and Health Form

Please review our Frequently Asked Questions regarding the Health Form and Immunizations.

Health Form

The Center for Health and Wellness requires a Health Form to be on file in our office no later than July 1 for Fall semester and January 15 for spring semester. Failure to do so will result in an inability to move into on-campus housing or removal from classes. A physical examination is strongly recommended, but not required.

Here's what incoming students need to do:

Review the list of required immunizations (below) and the state's information about Meningococcal Disease and the vaccinations
Fill out your Health Form. Your health care provider must sign the following items that are attached to the health form:
- Tuberculosis Risk Questionnaire
- Immunization Record
- Physical Examination (recommended but not required)
Login to MyBentley to post the types and dates of your immunizations into your electronic medical record. Submissions are due by July 1. Instructions for submitting Immunization records online. (PDF)
Mail or fax signed hard copies (keep a copy for your own records) of the Health Form and Immunization records to:
Bentley University — Center for Health and Wellness
Rhodes Hall
175 Forest Street
Waltham, MA 02452

f. 781.891.3443

Questions? Call us at 781.891.2222 or email healthcenter@bentley.edu

Note: Students will receive an e-mail once the Health Form and Immunization Record has been reviewed ONLY if additonal information is needed.

Please review our Frequently Asked Questions regarding the Health Form and Immunizations.

Immunization Requirements

Massachusetts college immunization laws require ALL full-time undergraduate students (12 or more credits) and full-time graduate students (9 or more credits) studentsto have the following immunizations on file at the University.

Students who are not in compliance will not be allowed to move into on-campus housing and attend classes.

Please note: There will be an immunization clinic on move-in day, Tuesday, August 28, 2012 for any new students arriving who need any required vaccines. This includes the meningitis vaccine. There will be a charge for the vaccines: cash, check or credit cards will be accepted. Please consult with your insurance provider to see if these costs can be reimbursed. The immunization clinic will be held at The Center for Health and Wellness, located in Rhodes Hall, from 10:00 a.m. to 3:00 p.m.

List of Required Immunizations
Hepatitis B Vaccine	3 doses required OR documentation of a positive antibody titer (HHsAB)
Measles, Mumps, and Rubella (MMR)	2 doses of the combined vaccine are required. The first dose should be given after the student’s first birthday. If the vaccine dates are not accessible, a blood test to determine immunity to Measles, Mumps, and Rubella is acceptable. Student will need the combined MMR vaccines if there is no immunity. Histories of Measles, Mumps, or Rubella diseases are NOT acceptable.
Meningococcal Vaccine (Meningitis vaccine) Menomune Menactra Menveo	1 dose within the last 5 years, or a signed waiver. (Download the State of Massachusetts meningitis vaccine waiver form)
Tetanus-Diphtheria-Pertussis (TdaP)	1 dose within the last 5 years for Freshman (class of 2016) and sophomores (class of 2015) For all students a Td within the past 10 years is acceptable.
Tuberculosis	All students must fill out the Tuberculosis Risk Questionnaire found in the Health Form. If found to be at high risk, a health care provider must complete the Medical Evaluation for Latent Tuberculosis.
Varicella (chickenpox)	2 doses given at least 1 month apart OR documentation of a positive antibody titer OR documentation of reliable history of Varicella Disease verfied by a Health Care Provider