New Undergraduate Student Health Forms
All incoming students must complete required forms and provide required documentation in their Student Health Portal to begin their time at Middlebury.
Students in summer programs should follow the instructions and expectations communicated by their programs with respect to health insurance coverage and immunization requirements.
Student Health Form Due Dates
- June 15 for fall admission
- December 1 for February admission
Log Into Your Student Health Portal
Log into the Student Health Portal using your Middlebury College single sign-on credentials to begin completing forms and uploading immunization information.
Required New Student Health Forms
The following forms must be completed by all students in the Student Health Portal under My Forms:
- Health History Form
- Emergency Contacts Form
- Confidentiality and Consent to Treat Form
- Tuberculosis Screening Form
The following forms and documents are conditionally required, and must be completed and/or uploaded to the student health portal prior to arrival on campus for all new undergraduate students for whom they apply. Please read the list below carefully to determine whether you are also required to complete one or more of the following forms:
- Provider Tuberculosis Status Form: for students who are determined to be at risk for tuberculosis based on the Tuberculosis Screening form in the student health portal.
- Provisional Admittance Form: for students who will not be in compliance with Vermont regulations for immunizations by when they arrive on campus and have a plan to meet the requirements within six (6) months of arrival.
- Consent Form for Treatment of a Minor: for students who will arrive on campus under the age of 18 (requires parent or guardian signature)
- Documentation related to the following status(es) for students who will be minors at the time of matriculation (under 18 years old) and are able to consent to all healthcare independently in the State of Vermont because they are: married, have previously been married, are on active U.S. military duty, or have been emancipated by court order.
First-time student athletes must also ensure that they have completed all required conditions and forms, including a new physical within six months of the start of their season, as outlined by Sports Medicine to be eligible for clearance to practice and compete.
Please note that all forms must be in English or accompanied by an English translation, and legible if they are handwritten.
When portal forms have been completed in the portal or copies have been uploaded and reviewed, they will disappear from your list in My Forms.
Required Vaccines under Vermont State Law
All Middlebury College students must come to campus with the Immunizations Required by Vermont Law. New students must obtain a copy of their up-to-date immunization record and compare it with the requirements to attend college in Vermont:
- Diphtheria
- Hepatitis B
- Measles
- Meningitis (ACWY)
- Mumps
- Pertussis
- Rubella
- Tetanus
- Varicella
New students who are unable to acquire all required immunizations (e.g. lack availability in country, time required between doses in a series, etc.) should reach out to Health Services at 802-443-3290 or via email healthservices@middlebury.edu to make a plan for immunization compliance.
New students who have a physical or wellness exam scheduled before they arrive on campus should not wait until that appointment if they are missing immunizations. Calling your healthcare provider and/or local pharmacy to explore immunization options as soon as possible can avoid delays and unwanted exclusions from campus.
When immunization records have been reviewed and approved, a green check mark will appear next to the immunization name at the top of the student health portal homepage. Required immunizations that do not have reviewed and approved documentation in the portal will have a red x mark next to the immunization name.
Religious or Medical Exemptions
Students who have religious or medical exemptions for required vaccines must complete the Vermont College Immunizations Exemptions Form as applicable and upload the form in their student health portal as an Immunization Exemption.
Exclusion from Campus
Unvaccinated students (i.e., those with vaccination exemptions) may be asked to miss class or leave campus at their own expense in the event of local cases of a communicable disease or an outbreak. This includes students who have been provisionally admitted and are working toward compliance with Vermont State requirements with Health Services.
Students who are provisionally admitted and are not in compliance with Vermont State requirements after six (6) months from their arrival on campus will be referred to the Dean of Students to be placed on a mandatory leave of absence. In order to return, students will be required to furnish immunization records in compliance with the requirements.
Health Insurance Card Information
New students must also upload images of the front and back of all health insurance cards including primary, secondary, dental, and pharmacy if you have separate policies.
Uploading Documents and Images to the Student Health Portal
When uploading documents or images to the portal, it is important to select the correct Document Type to expedite the review and approval of your images. Below is a table identifying common file uploads and the best Document Type to select.
| Uploaded Item | Document Type |
|---|---|
| Immunization Record | Immunization Record |
| Healthcare Provider Form/Physical Exam | Healthcare Provider Form |
| Provider Tuberculosis Status Form | Provider TB Form |
| Insurance Card(s) | Insurance Card Primary Insurance Card Secondary Insurance Card Dental |
| Religious and Medical Immunization Exemptions | Immunization Exemption |
New Student Frequently Asked Questions
I have submitted my health portal forms but they aren't disappearing from my list, what should I do?
Scroll back up through the form and look for any red “X” marks, indicating a required field, missing information, or improperly formatted information. Once you’ve corrected your entries, the “X” will disappear and you can click Submit again.
I'm trying to upload required images or documents to my health portal, but they aren't going through. What should I do?
Check to see if your document(s) are too large. There is a 10 MG limit per upload to the Student Health Portal. Also check to see if you are uploading using one of the listed, accepted formats. If you have verified that both the size and format are correct you can fax the documents to 802-443-2066 as a last resort.
Why can't I get into the Student Health Portal?
To log into the Student Health Portal you must have activated your Middlebury College account which results in your access to your Middlebury email address and the creation of a single sign-on password.
Register for the Student Health Portal using your username@middlebury.edu address. Enter your password for your Middlebury account and your multi-factor authentication (MFA) challenge, if prompted.
Access to set up your Middlebury credentials and the ability to use them to log into the Student Health Portal are typically granted to new undergraduates in mid-May. Review your canvas course for access dates.
Some of my documents are multiple pages. Should I upload each page separately?
No, documents should be uploaded as complete, multi-page documents when necessary. Scan all existing pages into one document (less than 10 MB), and upload into the appropriate category from the Document Type drop down menu, from the Document Upload Tab. If your document is larger than 10 MB in size, split the pages into as many sections as necessary to upload them in parts ensuring that the pages are accurately numbered.
I am an international student having difficulty accessing immunization records. What should I do?
Ideally, testing and/or immunization happens prior to arrival at Middlebury; however, Health Services staff will work with ISSS and international students who need help receiving vaccines that may be difficult to receive in their home countries.
I don’t have any immunization records, but I think I got shots. What should I do?
In some cases, students without evidence of immunization can submit blood test results that show immunity against varicella, measles, mumps, rubella, and hepatitis B. Ask your doctor if these tests are available and upload the results.
Get as many of the required immunizations as possible and upload your immunization record (in English)to your student health portal. If you get some immunizations just prior to arrival, bring a copy of your updated immunization record with you.
What if I am missing an immunization?
You can submit blood test results that show immunity against varicella, measles, mumps, rubella, and hepatitis B or get the missing immunizations at your healthcare provider’s office, an urgent care center, or even a pharmacy in some states. Be sure to get and make copies of the immunization and upload them to your student health portal. It is always a good idea to bring a copy with you as well.
I received an email saying Center for Health and Wellness offices have not received anything, but I sent in my documents. What should I do?
There are a variety of issues that can occur when trying to upload documents. Sometimes documents are too big for uploading, or they may have been uploaded to the wrong section or assigned the wrong Document Type. Please refer to the troubleshooting section of this web page.
If there is an upload link available on your portal page, you can try to upload the document again. If you’re still stuck, call Health Services at 802-443-5135.
My immunization dates are really close but are not consistent with the Vermont rule. What should I do?
The Vermont immunization requirements are consistent with current recommendations by the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices. In order for you to be compliant with the Vermont immunization rule, you must meet these date recommendations.
If you do not, you can ask your healthcare provider to do a blood test to see if you have immunity, or simply have another dose of the immunization. We strongly encourage you to speak with your healthcare provider and resolve the issue as soon as possible. Please resubmit any new information as soon as possible.
My doctor told me I was all set, but the Center for Health and Wellness is telling me I am not. Why, and what should I do?
The most common reason for students being told that they are not in compliance with Vermont immunization law is that the healthcare provider who reviewed their immunization record did not compare their records to the Vermont State requirements. Though the student has received immunizations, they were not administered in a manner consistent with current recommendations by the CDC Advisory Committee on Immunization Practices.
In order for you to be compliant with the Vermont immunization rule, you must meet the date recommendations. If you do not, you can ask your healthcare provider to do a blood test to see if you have immunity, or simply have another dose of the immunization. We strongly encourage you to speak with your healthcare provider and resolve the issue as soon as possible. Please resubmit any new information as soon as possible.
Can’t someone at the Center for Health and Wellness figure this out for me?
The required health forms and documents are the responsibility of each incoming student. New students are welcome to call (802-443-3290), email(healthservices@middlebury.edu), or set up a time to troubleshoot the student health portal or review their specific questions related to their health needs.
I'm having trouble accessing and/or using the Student Health Portal, where should I go for help?
Health Services staff can help during business hours (8:30am-4:30pm Monday-Friday) at 802-443-5135. You may also submit a Helpdesk ticket (email helpdesk@middlebury.edu).