Student Health Immunization Form

It is the policy of the university that all incoming freshmen are required to have adequate immunity to measles, mumps and rubella as a condition of attendance. In addition, Pennsylvania law requires all students living in university housing to certify that you have been immunized against meningococcal disease, or to sign a waiver that you decline the vaccine. You will receive more details from Student Health Services concerning immunizations in your PittStart confirmation packet.

All incoming freshmen must complete the Student Health Immunization form. You will receive a copy of the form in your PittStart confirmation packet, or you may obtain it from the link below. Please fill out the form and return to the following address:

University of Pittsburgh
Student Health Service
Medical Arts Building, Suite 500
3708 Fifth Avenue
Pittsburgh, PA 15213

Click here to print out the Student Health Immunization Form.

If you have any questions concerning the immunization policy, you may contact Student Health Services at 412-383-1832 or email studhlth@pitt.edu.