Health Records

Health Records is located in Room 118 in The Wellness Center on Trocaire’s Main Campus.


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.

Also, all students registering for six (6) or more credits must complete and return a Meningitis Response Form.

Registration Requirement:

Students will be put on a Health Hold when entering the college and not able to register for classes until all required documentation has been submitted to the Wellness Center.

Before Registration, all students must submit:

  1. MMR Immunization
  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.)

Meningitis: A signed 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 acknowledgement 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.

Submit Your Immunization Records

All Students must submit their required immunizations records prior to registration.

All immunization and other health documents should be submitted directly to the Health Records Office. This information can be scanned and emailed to (preferred)  , faxed (716-825-0416), mailed, or brought to the Health Records Office, Room 118 in the Wellness Center at 360 Choate Avenue, Buffalo, New York 14220.

Clinical Clearance

All Health Science students must have a complete Health Record on file before attending clinical. Students will obtain the information needed for their clinical site from their academic program and should submit all health related documents (including HIPAA, CPR, proof of Flu Shot) to Health Records in the Wellness Center.

Health Records Forms

The forms below are available for students to print copies of and return to the Health Records Office:

Medical and Immunization Record Packet

Medical History Form

Meningococcal Vaccination Response Form

Meningococcal Disease Fact Sheet

Exemptions from Immunization Requirements

Religious Exemption Immunization Form

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



Tina Hatchett, Coordinator of Health Records
Phone: 716.827.2579
Fax: 716.825.0416
Room: 118 Main Campus


Tadie Kowalski, Health & Wellness Assistant
Phone: 716.827.2489
Room:118 Main Campus