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NC Required Immunization and Health History Information

File cabinet drawer full of files an the first one is labeled Health HistoryThe general deadline for submission of the Immunization and Medical History form is June 15th.  All checklists on ConnectCarolina will be updated AFTER July 15.  

Students will be WITHDRAWN FROM THE UNIVERSITY 30 days after classes begin if immunization requirements have not been met and the Immunization and Medical History information have not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.

Please click the document link on the right for detailed instructions for completing the Immunization and Medical History Form.

Once you complete the online form, you will need to:

  • Print the form and 
  • Either have a medical provider sign the form to verify your immunization records or you can attach verified copies of your immunization record to the form. 
  • Include your FULL NAME & PID# on all pages you submit 
  • Mail, fax or email the completed form and any attachments to the Health Information Management Department:

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:

****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.****

For more information regarding immunizations, please call 919-966-2283 or email questions to  Please be sure to include your full name and PID # in all correspondence.  

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.

For questions relating to exemptions from NC Required Immunizations, please click ---> Immunization Exemptions