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Forms

In preparation for any health care needs you may have while attending Young Harris College, the Health & Wellness Service staff asks that you complete and return each of the forms listed below to Health & Wellness Services before you attend START Orientation.

REQUIRED FORMS

Health History Form

Every student at Young Harris College is required to submit a Health History form before attending classes. When listing Emergency Contact information, be sure that the first contact is a parent or legal guardian. If you are married, the first contact should be your spouse. If you answer "yes" to any of the questions on the history form, you should provide appropriate details in the right-hand column.

Meningitis Form

Certain college students are at increased risk for meningococcal disease, a potentially fatal bacterial infection commonly referred to as meningitis. In fact, freshmen living in residence halls are found to have a six fold increase risk for the disease. A U.S. health advisory panel recommends that college students, particularly freshmen living in residence halls, learn more about meningitis and vaccination. 

The State of Georgia requires that all post-secondary institutions provide information about bacterial meningitis to first-year students.  Please read the Meningitis on Campus Information Sheet prior  to signing the Acknowledgement of Receipt of Meningitis Information Form.

Certificate of Immunization Form

This must be completed by a doctor or health department. You must have documentation of two MMR (measles, mumps, rubella) shots, Tetanus shot (within the past 10 years), TB test or negative chest X-ray (only if you answer “YES” to either question on the TB screening form) and indicate whether or not you have had the Chicken pox. If you haven’t had Chicken pox, you should take the varicella vaccinations. Ask your doctor or health department about them.

Be sure the doctor or health department certifies the immunization record on the bottom of the form. Alternately, you may submit other official immunization documentation provided by your doctor or health department as long as the documentation addresses all the vaccinations that are listed on the Young Harris College Certificate of Immunization.

Tuberculosis (TB) Screening Questionnaire

All students are required to complete the TB Screening Form which is part of the Certificate of Immunization. Please read and follow the instructions for the questionnaire carefully.

For more information, contact Health and Wellness Services.