A Complete Immunization Record is required for all full-time students. 

Please return all required records and forms by your Orientation date or University deadline.

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:

The Code of Virginia section 23-7.5 requires students to provide documentation of their immunization by a licensed healthcare 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.

Required Forms

Please complete all applicable forms prior to your appointment.

New Patient Demographic and Health Center Policy Forms (pdf) 
All new patients: students/faculty/staff/spouses

New Patient Health History Form (pdf) 
All new patients: students/faculty/staff/spouses

Tuberculosis Screening and Immunization Forms (pdf)
All incoming new students

Allergy Immunotherapy Policy and Consent Form(pdf)
Those planning on receiving allergy injections

Proof of Immunization

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 their next semester.

Submit Records

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 studenthealth@longwood.edu.

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 fax number where you want the record sent.

Immunization Clinics

UHC has partnered with the Prince Edward County Health Department for immunization clinics held throughout the year at the LUHC. These clinics are an excellent opportunity for students to get up-to-date with required immunizations for enrollment. Check the LUHC facebook page for upcoming dates. 

Explanation of Immunization Requirements


Is it Required ?ImmunizationInformation
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. At least 1 does after age 16.
Required Hepatitis B Given as a series of three vaccines.  Vaccine or signed waiver required by Virginia state law
Required Polio (1) Primary immunization with a total of three [3] doses of OPV (oral Sabin) or
(2) Primary immunization with a total of four [4] 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 the disease.
Optional  Men B 2-3 dose vaccine based on age and manufacturer.