Incoming Student
 

Dear New Student/Parent of New Student,

Congratulations upon your acceptance to Brevard College.

PLEASE PROVIDE A COMPLETE HEALTH PROFILE. 

THE FOLLOWING ITEMS ARE REQUIRED BY BREVARD COLLEGE: 
(all forms are in PDF and require Adobe Reader available at the Adobe Website)

  1. Report of Health History
  2. Physical Examination – Need physician signature
  3. Immunization Record – Need health care provider signature
  4. Required Student Health Insurance Form – Copy of insurance card
  5. Emergency Contact Information

COMPLETE THE HEALTH HISTORY & PHYSICAL EXAMINATION FORMS         

COMPLETE THE IMMUNIZATION FORM

Immunizations required for enrollment at Brevard College:
  • Students 17 years of age or younger..........Required:
    • 3 DTP (Diphtheria, Tetanus, Pertussis) or Td (Tetanus, Diphtheria) doses: one Td booster must have been within the last 10 years.  Note:  if any updated booster is needed after 7/1/08, the new Tdap is required.
    • 3 Polio (oral) doses
    • 2 Measles (Rubella), 2 Mumps, 1 Rubella (MMR is preferred vaccine)
    • INTERNATIONAL STUDENTS:  If the MMR is not available in your country, you must have 2 mumps as well as 2 measles & 1 rubella
  • Students born in 1957 or later and 18 years or older...........Required:
    • 3 DTP (Diphtheria, Tetanus, Pertussis) or Td (Tetanus, Diphtheria) doses: one Td booster must have been within the last 10 years.  Note:  if any updated booster is needed after 7/1/08, the new Tdap is required.
    • 2 Measles (Rubella), 2 Mumps, 1 Rubella (MMR is preferred vaccine)
  • Students born before 1957..........Required:
    • 3 DTP (Diphtheria, Tetanus, Pertussis) or Td (Tetanus, Diphtheria) doses: one Td booster must have been within the last 10 years.  Note:  if any updated booster is needed after 7/1/08, the new Tdap is required.
    • 1 Rubella dose (not required if stuents are 50 years of age or older).
COMPLETE THE HEALTH INSURANCE FORM
  • Provide a copy of the insurance card with Health Insurance Form
COMPLETE THE EMERGENCY CONTACT FORM

Please provide the required health records listed above to Campus Life:
Brevard College
Attn: Campus Life
One Brevard College Drive
Brevard NC, 28712

Campus Life - 828-884-8258
Health Clinic – 828-884-8244
Health Clinic Fax – 828-884-8293

For further assistance, please do not hesitate to contact Campus Life at 828-884-8258.