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A record of all immunizations is required for all full-time students.
Full-time is 12 or more undergraduate hours and 9 or more graduate hours. You can download the Certificate of Immunization by choosing one of the options below:
Immunization Record (pdf)
- You must have your primary care provider or health department clinician review and sign the immunization record to insure accuracy and completeness.
- Please note that Hepatitis B is now required. All entering students must either receive the shot series or sign a waiver.
- Requirements for Nursing and Athletic Training Majors are noted on this form.
- Commonwealth of Virginia Certificate of Religious Exemption (pdf)
The Code of Virginia (Section 23-7.5) requires students to provide documentation of their immunization by a licensed health professional. If you are unable to provide appropriate documentation, vaccines may be repeated. If you neglect to submit this form, or if your immunizations are not up to date, a hold will be placed to prevent class registration.
Please note all students must provide verification of two doses of the MMR vaccine. Click here for more information: Strategy to Protect College Students from Mumps (pdf)
Also, the Longwood University Policy requires students to provide proof of immunization upon enrollment. Failure to comply with this policy can result in the student being unable to register for the following semester!
- Fall Semester - July 10
- Spring Semester - January 10
Mail your completed form to:
Student Health and Wellness Center
201 High Street Farmville, VA 23909
Request for Immunization Records
If you would like to request that copies of your immunization records be sent to either yourself or to another person or institution, please email a request with the following information to email@example.com.
Include your name (if it is different than when you were a student, please list name at that time), your date of birth, the reason that you are requesting the record, and the place and address where you want the record sent.
Explanation of Immunization Requirements
|Is it Required ?||Immunization||Information|
|Required||MMR (Measles, Mumps, Rubella combination vaccine)||Two doses of live vaccine are required after 12 months of age (dates prior to 1968 are not considered live). The second dose is to be given at least one(1) month after the first dose. Copies of immune titers are required if vaccine is not given. If you were born before 1957, you are considered immune (an MMR is not required)|
|Required||Tetanus / Diphtheria||Documentation of Primary (DPT) immunization series, including month/day/year of each dose, is requested. Tetanus/diphtheria booster (Td) (month/day/year) within the past 10 years is required.|
|Required||Tuberculosis Screening||Tuberculosis screening is required of all entering students, regardless of enrollment status. Not all students will require placement of the TB skin test, however if so, the test must be preformed within six months of entering. Refer to Screening Guidelines on the Certificate of Immunization.|
|Required||Meningococcal vaccine||Vaccine or signed waiver required by Virginia state law.|
|Required||Hepatitis B||Given as a series of three vaccines. Vaccine or signed waiver required by Virginia state law|
|Requested||Polio||(1) Primary immunization with a total of three  doses of OPV (oral Sabin) or
(2) Primary immunization with a total of four  doses of IPV (injected Salk).
Note: Documentation of prior vaccination against polio, including month/day/year of each dose, is requested. However, if documentation is impossible, it is not recommended that the student complete the primary polio series unless the student is younger than 18 years or is planning travel to an area endemic or epidemic for polio.
|Optional||Varicella (Chicken Pox)||Given as one vaccine or a series of two vaccines, depending on age. Recommended if no history of disease.|