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Required Immunization History Form

ALL new first-year, transfer, graduate, and international students must submit the ESF Immunization History Form.

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Immunization History Form (PDF)

Review of Your Record

The ESF Division of Student Affairs does not review or evaluate immunization records. Instead, the ESF Immunization History Form, accompanying records, and exemption requests are provided by students to the ESF Student Health Service @ Crouse Medical Practice via the ESF Student Portal only for review and evaluation. Instructions for submitting via the portal will be provided to students well in advance of the stated deadline. Any questions can be directed to the Division of Student Affairs at (315) 470-6660.

Your Immunization History Form must be submitted by:

  • September 25 (for Fall admits)
  • January 15 (for Spring admits)

Per New York State law, we are required to collect this information.

Pursuant to NYS Public Health Law § 2167, all students regardless of age, must read and certify that they have been informed about meningitis.

Any student who believes they should be exempt from the immunization requirements must follow the directions on page 3 of the Immunization History Form before the deadline to request an exemption.

Failure to submit the ESF Immunization History Form by the identified deadline may result in your class schedule being cancelled.