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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 Health 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Students will be WITHDRAWN FROM THE UNIVERSITY 30 days after classes begin if immunization requirements have not been met and the Immunization and Medical History information have not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 Health 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 and print the online form, you will need to:

  • Either have your local health care provider sign the printed form to verify all immunization dates on the form OR you may attach copies of a verified certificate of immunization in lieu of getting a health care provider signature. *****A verified certificate of immunization must include the name, address, sex, and date of birth of the student. The certificate must also include the name, number of doses, and the dates of all vaccines given as well as the name and address of the medical provider, clinic or local health department administering the required immunizations. If the immunization certificate is coming from a previous school, we can accept the record if the school stamps the record with their official seal/stamp. 
  • Sign the Patient Agreement and complete the TB Screening form that prints with the Immunization and Health History Form.
  • Upload all completed and signed documents as a single file by June 15th into the To Do List item on your Student Services page in ConnectCarolina (accepted file formats are .pdf and .tiff **please note there is a 5mb file size limit).
  • If you are missing vaccine requirements, an additional To Do list item will be added to your account indicating what requirement has not been met.

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.  PLEASE DO NOT EMAIL, FAX OR MAIL IMMUNIZATION AND HEALTH HISTORY FORMS, ALL FORMS MUST BE UPLOADED INTO CONNECTCAROLINA THROUGH THE TO DO LIST ITEM.

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