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Immunization Compliance Office
209.946.2315 option 5
Cowell Wellness Center
Annabelle Zamora
Immunization Compliance Coordinator
3601 Pacific Avenue
Pacific Health Services
Stockton, CA 95211

Health Profession Students

Printable Health Requirement Checklist  

(Audiology, Athletic Trainers, Dental Students, Dental Hygiene, Music Therapy, Occupational Therapy, Pharmacy, Physical Therapy, Physician Assistant, Speech Language Pathology)



 Login: - located under the Medical Clearance Tab.

  • Complete Health History Questionnaire
  • Enter immunization dates AND submit records/lab documentation
  • Acknowledgement of Patient Lab Service Policy
  • Acknowledgement of No Show Cancellation Policy & Fee Schedule
  • Acknowledgement of Receipt of Notice of Privacy Practices
  • Health History and Physical Examination
    • Physical Examination Form to be completed no greater than 3 months prior to matriculation
    • Pharmacy/Physician Assistant Students: Annual Requirement

  • Hepatitis B Surface Antibody Titer (Blood Test)
    • Hepatitis B Surface Antibody titer showing immunity (quantitative preferred; qualitative accepted).
    • For negative titer/blood test: Provide documentation of any previous Hepatitis B vaccination(s) and/or demonstration that the vaccination series has been restarted.
    • Pharmacy/Physician Assistant Students: Quantitative Hepatitis B Surface Antibody titer showing immunity as a numerical value (within 5 years)

  • MMR (Measles, Mumps, Rubella) Series
    • Two documented doses OR antibody titer showing immunity (quantitative preferred; qualitative accepted)
    • Pharmacy/Physician Assistant Students: MMR antibody titer showing immunity (within 5 years)

  • Varicella Vaccine (Chickenpox) Series
    • Two documented doses OR antibody titer showing immunity (quantitative preferred; qualitative accepted)
    • Documentation of Varicella disease is not acceptable
    • Pharmacy/Physician Assistant Students: Varicella Antibody titer showing immunity (within 5 years)

  • Tdap Vaccine (Tetanus, Diphtheria, Acellular Pertussis) Td Vaccine (Tetanus, and diphtheria toxoids)
    • One documented dose of Tdap (after age 10)
    • Td booster every 10 years
    • Physician Assistant Students: Tdap within 3 year of matriculation
  • Influenza Vaccine (Annual Requirement due by November 1st)
    • Influenza Vaccination Declination Form  * please check with your program coordinators about your clinical site mandates and mask requirements. If you wish to decline the flu vaccine; This form will need to be submitted both to your program coordinator and a copy uploaded to your medical portal. 
    • Documentation of the influenza vaccine for the current season
  • Tuberculosis Testing Requirement
    • No history of positive PPD test or disease
      • 2-step PPD screening or QFGT blood test within 3 months of matriculation
      • Physical Therapy Students: To be completed between September 14th – September 30th
      • Physician Assistant Students: Complete by November 15th
    • History of positive PPD or disease
      • Chest X-ray within 6 months of matriculation.
      • Documentation of previous BCG vaccination, latent TB or active TB treatment
    • Annual Requirement:
      • No history of positive PPD or disease: 1-Step PPD (2-step PPD required if 1-step PPD is not completed on/or before annual due date)
      • History of positive PPD:  Complete Tuberculosis Review Form
      • Pharmacy Students: Annual 2-Step PPD
      • Physical Therapy Students: QFGT (Completed September 14th – September 30th)
  • Meningococcal Conjugate Vaccine
    • One documented dose given on or after 16 for all students who are under 22 years of age.


For more information about Student Health Insurance and Waiver Requirments