Health Center

The University of Mississippi

Health Requirements and Forms for New Students

Deadlines

• All entrance medical requirements for freshmen are due before registering for orientation.
• International students must have meet all immunization requirements established for domestic students and a chest X-ray (performed at Student Health Services) prior to registration for courses.

Requirements and Forms

Please read the material below, then mail or fax the required information prior to registering for orientation.

Mailing Address:

V.B. Harrison Student Health Services

PO Box 1848

University, MS 38677

Fax: 662-915-5292

1. Certificate of Compliance (Save PDF to desktop for a fillable and accessible version.)

2. Medical History Form (comprehensive medical records are NOT required)

3.Tuberculosis Screening (International Students)

                            4. Release of Protected Health Information

1. Certificate of Compliance- (MMR immunization records)

Measles, mumps and rubella are serious communicable diseases that can spread in close living or classroom environments. All students, including transfers, must be vaccinated to prevent these outbreaks. You must show proof of immunity before you can register for orientation.

Proof of immunity to measles, mumps, and rubella must be submitted in one of the following ways:
  • a physician statement documenting prior infection of measles, mumps and rubella
  • blood test (serology confirmation of measles, mumps, and rubella immunity)
  • documentation of two MMR vaccines by providing:
    • Certificate of Immunization Compliance Form 121 (MS residents) or 
    • Immunization records provided by your State Health Dept. or local physician’s office or
    • Certificate of Compliance form found in link above
Timing of MMR administration:
  • Individuals born after January 1, 1957, are required to have two doses of measles (rubeola) vaccine given after 12 months of age. Immunizations must be repeated if given at less than 12 months of age, or before January 1, 1968. There must be a minimum time interval of four weeks between the two doses of measles vaccine.
  • Two mumps vaccinations after the age of 12 months.
  • Two rubella vaccinations that were administered after 12 months of age (on or after January 1, 1969)

Note: These were usually given together as MMR.

Permanent and Temporary Exemptions to this policy can be found at http://secure4.olemiss.edu/umpolicyopen/ShowDetails.jsp?istatPara=1&policyObjidPara=10646114

2. Medical History Form-  (comprehensive medical records are NOT required)

The Medical History Form gives the V.B. Harrison Student Health Center staff prior information enabling us to treat you safely and effectively. The information is electronically secure and completely confidential. It cannot be released without your consent, except as required by law. If you do not complete this form with all required information, it will be returned to you for completion.

 

3. Tuberculosis Screening

Screening for Tuberculosis is required for all international students entering the University of Mississippi for the first time. A chest X-Ray and a blood test (interferon gamma release assay, i.e. IGRA) is required prior to registration for courses and must be done in our facility. Chest x-rays and/or reports from outside the USA will be not accepted.

International students entering The University of Mississippi for the first time are also required to meet the same immunization requirements as domestic students. See Certificate of Compliance described and linked above. If you have not had the required immunizations or are unable to obtain the Measles, Mumps, and Rubella (MMR) in your country, contact the Student Health Center or the International Office to learn how you can get the immunizations once you arrive on campus.

4. Authorization for Release of Protected Health Information

The HIPAA privacy rule became effective April 14, 2003, and established standards for information disclosure including what constitutes a valid authorization. HIPAA applies to covered entities, defined by the rule to include health plans, healthcare clearinghouses, and healthcare providers that transmit specific information electronically.

Legal Requirements

HIPAA

Section 164.508 of the final privacy rule states that covered entities may not use or disclose protected health information (PHI) without a valid authorization, except as otherwise permitted or required in the privacy rule.

adapted from: http://library.ahima.org/doc?oid=107284#.WxgmhiBOmUk