Forms for new and transfer students entering Fall 2019:

Student Health Insurance

  • Please be sure to review the Student Health Insurance Plan and, if you have comparable private insurance, to waive out at www.gallagherstudent.com/conncoll. You must also email a copy of your private insurance card, front and back, to Student Health Services at SHS@conncoll.edu.

Health History Form

  • Connecticut College Health History Form (filled out via the Student Health Services' Web Portal, http://connc.studenthealthportal.com/).
    The due date for completion of this form is July 1, 2019.

Physical Exam, Immunizations & Tuberculosis (TB) Screening Questionnaire

  • Please note that Connecticut state law requires that all full-time or matriculating students, born after December 31, 1956 who are attending higher education programs in Connecticut, must provide proof of adequate immunization against measles, mumps, rubella and varicella. Additionally, state law requires that students who reside in on-campus housing be vaccinated against meningitis and submit evidence of having received a meningococcal conjugate vaccine not more than five years before enrollment as a condition of such residence. A copy of the statute is available at https://www.cga.ct.gov/current/pub/chap_185b.htm#sec_10a-155.

The college, following recommendations from the Connecticut Department of Health, requires Tuberculosis screening for all new students, both domestic and international.

 

  • All new students must download/print the Student Physical Exam form and Certificate of Immunization Form and have them completed by a Health Care Provider.
  • All new students must print and complete the CC Tuberculosis Screening Questionnaire. Students with a positive TB screen will need to download/print the CC Tuberculosis Testing Form and review the form with a Health Care Provider for evaluation for TB testing. Students born in one of the countries with high TB prevalence identified on the CC Tuberculosis Screening Questionnaire, will need to schedule an appointment with Student Health Services (SHS) once arriving on campus for onsite TB testing.
  • Once completed, forms can be scanned and uploaded to the  Student Health Services' Web Portal, http://connc.studenthealthportal.com/ under "Document Upload," or scan and email them to SHS@conncoll.edu, or fax them to SHS at (860) 439-5430.
  • The due date for completion of these forms is July 1, 2019. If your physical is not scheduled until after July 1, 2019, please be sure to submit the completed forms and then submit your physical once it is complete.

 

Connecticut College is also required by CT statute to provide information regarding meningitis and Hepatitis B infections and the benefits of vaccination.

Meningitis: http://www.immunize.org/catg.d/p4210.pdf

Hepatitis B: http://www.immunize.org/catg.d/p4205.pdf