Get Miami Dade College Medical Campus Student Health Record Form - Mdc

Completing the MIAMI DADE COLLEGE MEDICAL CAMPUS Student Health Record Form is essential for students entering clinical programs. This guide provides clear, step-by-step instructions to help users effectively fill out the form online.

Follow the steps to complete the Student Health Record Form online.

1. Click ‘Get Form’ button to access the MIAMI DADE COLLEGE MEDICAL CAMPUS Student Health Record Form and open it in your editing tool.
2. Begin with Section 1: Personal Information. Fill out all required fields including your name, student number, address, date of birth, and emergency contact details.
3. Proceed to Section 2: Required Influenza Injection. Enter the date of your influenza injection and ensure you sign the acknowledgment of its importance.
4. In Section 3: Required Titers/Tests, carefully complete the required titer information. Indicate vaccination and test results provided by authorized medical personnel. Remember, only test results will be accepted as documentation.
5. For TB Skin Test, list the dates and results of two tests. If applicable, attach additional results from QuantiFERON or a recent chest x-ray.
6. Complete Section 4: Hepatitis B Vaccine. Indicate whether you have initiated or completed the vaccine series or provide antibody test results if applicable.
7. Read and sign the Student’s Statement in Section 5, giving consent for the release of your health information to Miami Dade College and affiliated health care facilities.
8. Finally, in Section 6: Examiner’s Statement, ensure your health care examiner signs and confirms your ability to meet physical demands associated with the program.
9. Once you have completed all sections, save your changes. You can now download, print or share your completed Student Health Record Form as required.

Complete your documents online today to ensure your eligibility for clinical training at Miami Dade College.