Dear Thorobred:
Student Health Services recommends all students submit the Medical History Form, Preventative Health Care Examination Form, and an Immunization Record prior to attending Kentucky State University.
Documentation from a doctor or clinic regarding the following immunizations is recommended:
Preventative health care examination completed by doctor or clinic within the past six months
Tuberculin Skin Test within the past six months
Copy of chest X-ray if history of positive tuberculin test
Recommended immunizations include:
Polio Series (x 4)
Adult Tdap (within the past 10 years)
Meningitis Vaccine (up to age 26)
Mumps (MMR x 2 or documentation of disease)
Varicella Vaccine/Chicken pox (x 2 or documentation of disease)
Note: Documentation of disease should be verified or signed on a physician's or clinic's letterhead.
Please send the following completed forms and immunization record to:
Office of Admissions Kentucky State University ASB Suite 312 400 E. Main St. Frankfort, KY 40601
Or fax to: (502) 597-5814
Thanks for your cooperation!
Sincerely,
Floarine A. Wilson, APRN Director, Betty White Health Center
Rev 2/22/16