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Health Examinations

Prior to entering one of Clark College's Allied Health programs, you will need to provide the following information (please print this page to take to your health care provider):

image of a checked boxA completed physical form, or if you are starting the phlebotomy program, a medical history form. (available at Health Services, 360-992-2614)

image of a checked boxCopies of your immunization records, which must contain:
  • Two doses of MMR (measles, mumps and rubella) or one dose of measles vaccine and one MMR, given at least one month apart, given after your first birthday
  • The first two of three doses of Hepatitis B vaccine, given at least one month apart.
  • If you have not had the chicken pox, you need two doses of Varicella vaccine given at least one month apart, given after your first birthday.
  • If it has been over 2 years since your last Td (tetanus/diptheria) shot, the current recommendation for health care providers is to receive a dose of the new vaccine, Tetanus/Diptheria/Pertussis (Tdap) , which also protects againt whooping cough.


image of a checked boxBlood tests showing proof of immunity to measles, rubella, hepatitis B and varicella may exempt you from the vaccination, if the documentation is attached.

image of a checked boxTuberculosis Skin Testing (also known as PPD or TST), if you have never been tested for TB, or it has been greater than a year since your last test, a two-step test is required (two tests, given 1-3 weeks apart). If you have never had a two-step test, but have had a TST in the past 12 months, one additional TST will be needed.  In the case of a previous positive PPD, documentation of a clear chest x-ray or negative QFT-G must be provided. Please note the Nursing Program no longer accepts negative chest x-rays, and a QFT-G will be required.

image of a checked boxDuring Fall and/or Winter quarter, students may be required to be vaccinated against flu, please check with your program. 

Please send or fax the completed physical form and documentation to:
Clark College Health Services HSC 124
1933 Fort Vancouver Way
Vancouver, WA 98663-3958

Confidential Fax (360) 992-2853

If you do not have a health care provider or your insurance plan will not cover this cost, Clark College Health Services provides services to students at very low cost. Please call 992-2614 for an appointment, or should you have any questions about these requirements.





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Clark College - 1933 Fort Vancouver Way - Vancouver, WA 98663 - (360) 669 - NEXT


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