NC Required Immunization and Health History Information
North Carolina General Statute §130A 152-157 requires that all students entering college present a certificate of immunization which documents that the student has received the immunizations required by law.
The general deadline for submission of the Immunization and Medical History form is June 15th. Students will be WITHDRAWN FROM THE UNIVERSITY 30 days after classes begin if immunization requirements have not been met and the Immunization and Medical History information have not been received by Campus Health Services staff.
The Immunization and Medical History form can found on the Connect Carolina home page, under the More Student Links tab at the top of the page.
Once you complete the online form, you will need to:
Campus Health Services
Attn: Health Information Management Dept
Campus Box 7470, James A Taylor Building
Chapel Hill NC 27599-7470
Fax: 919-966-0616 Email: firstname.lastname@example.org
The June 15th deadline is only a general deadline, you have until classes begin in the fall to submit your completed form/records to our department.
Please click the document link on the right for detailed instructions for completing the Immunization and Medical History Form.
For more information regarding immunizations, please call 919-966-2283 or email questions to email@example.com. Please be sure to include your full name and PID # in all correspondence.