Health Records

Main campus, Room 118

Phone: (716) 827-2579 | Fax: (716) 825-0416

Email: [email protected]


Immunization & Meningitis Requirements

New York State Public Health Law 2165 requires all students attending New York State Colleges and Universities to show proof of immunity against measles, mumps, and rubella. Full-time and part-time students, registered for six (6) credit hours or more, must show proof of immunization. Persons born before January 1, 1957, are exempt from the requirement. In addition, students registering for six (6) or more credit hours must complete and return a Meningitis Response Form.

Registration Requirement:

A Health Hold is placed on all student accounts upon admission to Trocaire College. Students will not be able to register for classes until health and immunization records required by the College have been submitted to the Wellness Center.

Before registration, students must submit:

  1. MMR Immunization (Medical and Immunization Record Packet)
  2. Meningococcal Vaccination Response Form
  3. Medical History Form

Proof of Immunity:

Measles: Two doses of live measles vaccine given after 1967 and after 12 months of age, or physician documentation of mumps disease, or a blood test showing immunity. The second dose of live measles must be given no sooner than 30 days after the first shot.

Mumps: One dose of live mumps vaccine given after 1968 and after 12 months of age, or physician documentation of mumps disease, or a blood test showing immunity.

Rubella: One dose of live rubella vaccine given after 1968 and after 12 months of age, or a blood test showing immunity. (Physician documentation is not acceptable proof of immunity against rubella.)

Meningococcal/ Meningitis: A signed meningococcal/ meningitis response form indicating the date of the shot or declination of the meningitis shot.

New York State Public Health Law 2167 requires colleges and universities to distribute information about the meningococcal meningitis disease and vaccination to all students. The college is required to keep a record of immunization within the past ten years, or an acknowledgment of the receipt of information about the disease risk, and refusal of the meningococcal meningitis immunization signed by the student.

Meningitis is rare. However, when it strikes, its flu-like symptoms make diagnosis difficult. If not treated early, meningitis can lead to swelling of the fluid surrounding the brain and spinal column, as well as severe and permanent disabilities, such as hearing loss, brain damage, seizures, limb amputation, and even death. Cases of meningitis among teens and young adults 15-24 years of age (the age of most college students) have more than doubled since 1991. The disease strikes about 3,000 Americans each year and claims about 300 lives. Between 100 and 125, meningitis cases occur on college campuses and as many as 15 students will die from the disease.

A vaccine is available that protects against four types of the bacteria that cause meningitis in the United States æ types A, C, Y and W-135. These types account for nearly two-thirds of meningitis cases among college students.

How do I go about getting my immunization records?

Immunization records are typically available through your pediatrician’s office, your primary care physician’s office, previous colleges you have attended, your high school, and your health nurse in any health-related employment. It is important to remember that immunization records are not automatically forwarded to Trocaire College when you transfer. Due to medical confidentiality, you must request them to be forwarded separately from transcripts and other information.

Submitting Your Health Records:

All health record documentation must be scanned, labeled with your last name, first name, and emailed to: [email protected] or faxed to 716-825-0416. Students may also hand deliver records by dropping them in the locked, black box located outside of the Wellness Center (Rm. 118). Students are responsible for maintaining copies of any records submitted to the College.

In addition to health and immunization records required by the College, the Wellness Center maintains records required by each academic program. Each program has specific health record requirements.  For a current list of program requirements, students should refer to their specific program policy manual which can be found on the respective program Academic Program site.

Students must submit health and immunization records required by the College and their academic program to Wellness Center. 

Health Records Forms

Consent to Release Medical Information

Medical and Immunization Record Packet

Medical History Form

Meningococcal Vaccination Response Form

Meningococcal Disease Fact Sheet

Exemptions from Immunization Requirements

Hepatitis B Vaccine Form

TDAP – Consent for Tetanus, Diphtheria, and Pertussis (TDap) Vaccine Form

TST Skin Test (PPD) Two-Step

TST Skin Test (PPD)

TST and TST Annual Symptom Review

Request for Release of  Medical Information Authorization 

Physical Examination Form

Influenza Declination Form

Additional Resources:

WNY Healthcare:

Health Insurance Marketplace

*Please note, this list does not encompass all resources available and is subject to change.  This list does not constitute or imply the endorsement, recommendation, or favoring of these agencies.


Tina Hatchett, Coordinator of Health Records
Phone: 716.827.2579
Fax: 716.825.0416
[email protected]

Sasha Waskosky, RHIT
Health and Wellness Office Assistant
Phone: 716.827.2579
Fax: 716.825.0416
[email protected]