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Required Health Forms

Welcome to Anna Maria College! This page has information about required health forms and immunization documentation that must be completed before arriving on campus.

All required health forms and immunization documentation must be completed and uploaded to the Medicat Patient Portal by July 31st for Fall Semester Enrollment and by January 1st for Spring Semester Enrollment.

The State of Massachusetts Department of Public Health requires that a completed medical file for each student be maintained in Health Services. Each student must have a physical examination within one year of college entrance and, per Massachusetts Law 105 CMR 220.000, present evidence that they are adequately immunized against Measles, Mumps, Rubella, Varicella, Hepatitis B, and Meningitis, and that they have received a dose of Tdap vaccine.

Any student not meeting these requirements can be prevented from registering and attending classes, and/or moving into housing until the information is provided.

To meet these state and College requirements and to register students to allow them to access medical services on campus, Health Services has compiled a Welcome Packet for incoming students that includes necessary forms, instructions, and a check list. Please click here to download the Health Services Welcome Packet.

Anna Maria College has partnered with Medicat to manage our health records electronically and confidentially. Only Health Services staff have access to student medical records.

All health registration forms and documents must be uploaded to the Medicat Patient Portal; we are unable to accept forms by mail, fax, email, or in person. Please click this link for the login page to the Medicat System. Massachusetts residents, vaccination records can be accessed using the  Massachusetts Immunization Information System at: https://myvaxrecords.mass.gov/.

If it is your first time visiting, you will need to register. Once registered, you will be able to complete all your health service forms.

See below for individual form downloads and additional information about the process for completing these documentation requirements.

Downloads and Information

Steps for Completing Required Health Services Documents

Step 1: Download the Health Services Welcome Packet 

The packet includes a checklist of required forms and instructions for registering and uploading documents to the Medicat Patient Portal.

Step 2: Complete forms and gather required documents 

  • A physical exam dated within 1 year of admission to Anna Maria College (6 months for athletes) 
  • Immunization record, including copies of Covid-19 vaccination card(s) 
  • Review and sign the Consent for Treatment 
  • Review and sign the Authorization to Treat a Minor (for students under the age of 18 only)  
  • A copy of your health insurance card 

Step 3: Register for the Medicat Patient Portal 

 Step 4: Complete Online Forms in Medicat Patient Portal  

Under “Forms for Incoming Students” tab 

  • Student Health History & Emergency Contact Form 
  • TB Risk Assessment Questionnaire 
  • Acknowledgement of Receipt of Notice of Privacy Practices 

Under “Immunizations” 

  • Input Dates of Required Immunizations 

Under “Upload” Tab  

Upload Required Documents:

  • Immunization Record 
  • Physical Exam Form 
  • Consent for Treatment 
  • Authorization to Treat a Minor – only required for students under 18 
  • Copy of Health Insurance Card 

 

Health Services Form Downloads

Health Services Welcome Packet – includes all required Health Services forms and information for incoming students
Authorization to Treat a Minor – only required for students under 18
Immunization Waiver Request Form – only required if requesting waiver of immunization requirements
Meningitis Information and Waiver Form – only needed if waiving meningitis vaccination 

How To Register for the Medicat Patient Portal

Health Services utilizes an electronic health record system, Medicat, for all medical record documentation. Once students have received their Anna Maria College @amcats.edu email address they must register their username and password with the Medicat Patient Portal in order to upload required health documents to their medical record.
Here is a form for download that provides How-To directions to register for and navigate the patient portal.
Below is a video that walks you through the process as well.

Checklist of required Health Services documents and forms

Forms to be Uploaded
  1. Immunization Record
  2. Physical Exam Form
  3. Authorization to Treat a Minor – only required for students under 18
  4. Copy of Health Insurance Card
Forms to be completed Online in the Medicat Patient Portal
  1. TB Risk Assessment Questionnaire
  2. Consent for Treatment
  3. Student Health History
  4. Acknowledgement of Receipt of Notice of Privacy Practices

Medicat Portal Troubleshooting

THIS VIDEO provides step by step instructions for how to register and login to the Medicat Patient Portal. 

If you have questions or run into issues either registering or logging in, please make a note of any error messages and contact Health Services by email at healthservices@annamaria.edu or phone at 508-849-3315. 

FAQs

What Immunizations Are Required? 

Required immunizations for all students include: 

  • two-dose series of MMR 
  • three-dose series of Hep B 
  • two-dose series Varicella (or proof of history of disease) 
  • Meningococcal vaccine (for all full-time students, residential and commuter, 21 years of age or younger) 
  • Tdap vaccination. All international students need to have Tdap immunization within 12 weeks of arrival in the U.S. 
  • Covid-19 vaccination – initial vaccine series (two doses of pfizer, moderna or novavax, adjuvanted or one dose of janssen and janssen. 

Annual flu vaccination is also strongly recommended. 

For international students, WHO-approved Covid-19 vaccine series are acceptable.  

Do I have to use the Anna Maria College physical exam or immunization records forms? 

We will accept physical exam forms and a printed copy of immunization records from your primary health care provider, you are not required to use the Anna Maria College branded forms. 

 

Where can I review the Notice of Privacy Practices? 

Here is a link to a downloadable copy of our Notice of Privacy Practices.  

We are required to ask you to sign a written statement that you have received the Notice of Privacy Practices document, however you are not required to sign. We will still provide you with all our services. This statement is the Acknowledgement of Receipt of Notice of Privacy Practices and is an online form located on the Medicat Patient Portal “Forms for Incoming Students” tab. 

Can I waive immunizations? 

Yes.  The State of Massachusetts allows for Immunization waivers under two circumstances:

  • Religious Waiver: A request to waive immunization requirements on religious grounds requires a personal statement provided by the student that documents how the required immunization(s) conflict with their sincerely held religious beliefs. 
  • Medical Waiver: A request to waive immunization requirements on medical grounds requires certification from a licensed medical provider that the required immunization(s) is contraindicated due to a prior adverse reaction or current medical condition. 

 To submit a waiver request, download and complete the Waiver Request Form, and gather required supporting documentation depending on type of waiver being requested. You must then upload a scanned copy of your completed and signed Waiver Request Form and supporting documents to the Medicat Patient Portal Upload tab. Waiver requests for both medical and religious reasons must be re-submitted annually at the start of the school year. 

 The only exception to this process is a waiver request for Meningitis vaccination specifically. Meningitis vaccination is required for all College students age 21 and under. To waive the Meningitis vaccine requirement, you must download, review, and sign the Massachusetts State Meningitis Information and Waiver Form. Then upload a scanned copy of the completed form to the Medicat Patient Portal Upload tab.  

Additional Questions

If you have questions regarding required health forms, or problems accessing the Medicat Patient Portal, contact the Health Services Office at healthservices@annamaria.edu or by phone at 508-849-3315 for assistance.