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Medical Forms

Medical Services Entrance Form

The Medical Services entrance form is required for all first-year and transfer undergraduate and graduate students and is due June 15.

Students who study abroad or otherwise take time off from their on campus studies are required to update the demographic and tubercolosis screening portion of health forms upon return to campus.

Send completed forms to:

Smith College Medical Services
21 Belmont Avenue
Northampton, MA 01063
Fax: 413-585-4639

We do not accept emailed forms.

In order to protect the health and safety of each student and our community, failure to provide all required documents by June 15 will result in a hold being placed on your account. You will be unable to pre-register for classes until all requirements are met. Please contact us with any concerns you may have about completing the forms.

Students having difficulty scheduling appointments or obtaining vaccines with their health care providers may find that their local health department, walk-in clinic, urgent care center or pharmacy can provide required tuberculosis screenings, vaccines and/or physicals.

 

School for Social Work Students

For Spring/Summer 2019, we are excited to offer the ability to submit some required health information online. This is a new feature, and instructions will be available soon. Students submitting any portion of their required health information online must also submit physician verified information via mail or fax by deadline. Stay tuned for more information.

Students having difficulty scheduling appointments or obtaining vaccines with their health care providers may find that their local health department, walk-in clinic, urgent care center or pharmacy can provide required tuberculosis screenings, vaccines and/or physicals.


Medical Records Release Form

The release form is required to allow the transfer of medical information from Smith College Health Services to a secondary provider, such as your primary care provider at home or a referred provider.

Requests are fulfilled in the order in which they are received and may take up to two weeks to complete.


Frequently Asked Questions

If these FAQs don’t help you find the answers you need, please call us at 413-585-2250, or email us at healthservices@smith.edu.

Can I email you my forms?
NO. Email is not secure method of healthcare correspondence. We do not accept emailed records.

Where do I send my forms and records?
Send forms via fax or U.S. Mail to:

Smith College
Schacht Center for Health and Wellness
21 Belmont Avenue
Northampton, MA  01063
Fax: 413-585-4639

We do not accept emailed records. Don't forget to keep copies for yourself.

Can I just send vaccine records from my last school or my last doctor’s appointment to you?
Yes. However, do not assume you have received all required vaccines as requirements may change and vary from state to state. Massachusetts immunization requirements are very strict. Carefully review your records against the requirements to be certain you submit complete documentation.

I can’t get every required vaccine in my home country. What should I do?
Don’t worry. You can get all required vaccines at local pharmacies, such as CVS or Walgreens, in Massachusetts.

Can I waive vaccines? I did not receive standard childhood immunizations. What should I do?
We strongly recommend that all students receive immunizations as required for school entrance by the Commonwealth of Massachusetts. These requirements exist to protect the health of every individual student, our campus community, and protect the public health of our global population. Massachusetts allows exemption from vaccines for only two reasons: medical or religious exemption. Massachusetts does NOT recognize philosophical exemptions to vaccines. Students with valid exemptions must complete a Smith College vaccine exemption waiver by deadline date and prior to registration and orientation. Contact Kerry-Beth Garvey at the Schacht Center for questions and waiver instructions at 413-585-2250 or healthservices@smith.edu.

Students with further questions about vaccines, or medical or religious vaccine exemptions, are encouraged to review the information below and from the Centers for Disease Control and Prevention, and contact the Schacht Center with questions.

I can’t get an appointment for a physical in time to meet the deadline. What should I do?
Don’t worry. We will work with you. Most cities and towns in the US have walk-in urgent care clinics, and large pharmacies, such as CVS and Walgreens, have on-site clinics that offer physical exams, tuberculosis screening and vaccine administration. Please send us your immunizations and the parts you can complete and ask your regular healthcare provider to send us the rest. Keep copies for yourself!

I can’t find my immunization records. What should I do?
Call your most recent school or doctor’s office and ask if they have your immunizations on file. Check with your state, city or town to see if they have an immunization registry. Send copies to us. Keep a copy for yourself!

I can’t get Tuberculosis Blood Tests (IGRA Tspot or Quantiferon Gold) in my home country. What should I do?
If you arrive in Massachusetts before college orientation, please be in touch with us. We can arrange for you to have testing performed. We can also perform the test here on your first day of orientation.

My doctor’s office doesn’t provide Meningitis B vaccine. What should I do?
Don’t worry. Most large retail pharmacies such as CVS or Walgreens provide vaccines. Sometimes the pharmacist may need to order the vaccine. This vaccine locator tool can be useful in finding vaccines near you. We suggest you contact the pharmacy with any questions.

My insurance company doesn’t cover Meningitis B vaccine. What should I do?
Please contact your insurance company and ask for an appeal. Explain that there has been a recent outbreak in western Massachusetts at Smith College and the University of Massachusetts. Please refer to the welcome letter in your health form packet, call us, or refer to our website for more information.

I won’t finish the entire series of HepatitisB, MMR, MeningitisB, or Varicella vaccines in time for the start of school. What should I do?
Don’t worry. As long as we have proof that you started the series, we will consider your file temporarily complete and adjust your hold date. For example, if you received a vaccine in June and are due in November for your next dose, we will move your hold date to November. We will remove holds when all aspects of your health forms are complete.

Is there a place near campus I can get vaccines, or otherwise complete my forms ?
Yes. Northampton has several walk in clinics conveniently located near campus:

  • CVS Minute Clinic, 366 King Street, Northampton, 413-586-8315
  • Cooley Dickinson Urgent Care Clinic, 30 Locust Street, Northampton, 413-582-2330
  • ONCall Urgent Care Clinic, 6 Hatfield Street, Northampton, 413-584-7425

Do I need a TB test?
Only If you answer “yes” to the screening questions. Your doctor MUST sign the form.