______ Physical exam – Completed page 2 of Medical Form
______ Health history – Completed page 1 of Medical Form including signature
______ Immunization records – Completed and signed Immunization Form (pink form in the mailed packet)
______ Health Insurance – completed online waiver form or enrollment in the College’s Student Health Plan
______ Meningitis Response Form signed
______ Sports physical if new to athletics and last exam was over six months ago
REFERENCE AND FREQUENTLY ASKED QUESTIONS (FAQ’s):
Required of all newly admitted students, the physical exam must have been completed within 1 year of starting classes.
Athletes need a full physical on entrance into sports and then a history update annually thereafter.
Students in Daycare, Equine, Education, and Human Service internships may need a yearly health clearance and TB test as directed by the adviser for the program.
1. Can I use my sports physical done in the high school? No. If not done by your own provider, sports physicals are available on campus for $35.
2. Can I use my physical from the last college? Yes, unless you have taken semesters off before transferring.
3. Can I get a physical at the college? Yes, the charge is $40 and it can be scheduled upon arrival. Sports physicals are $35.
Health History Form
Page one of the medical form includes identifying information, emergency numbers, the health history, and authorization for emergency treatment. This form must contain a signature at the very bottom of the sheet. Parental signature is required if the student is under 18 upon arrival to campus.
1. Do I have to use the college’s form? No, not if the form used includes all of the above information.
This portion of the medical record is mandatory and will delay registration or program participation and result in dismissal from class if not received according to the State Health Department guidelines. A doctor or a nurse should complete and sign the College’s form or attach copies of official records. Family doctors, schools, and the military are places maintaining shot records.
Mandatory by NY State Law:
2 measles shots, 1 mumps shot, 1 rubella shot OR 2 MMRs
Blood tests showing immunity are also acceptable
Students born before 1/1/57 are exempt
Required by the Institution:
Tetanus shot – done within 10 years
Polio series - completed as a child
TB test - done within 1 year of starting classes if student is foreign-born or from an identified high-risk population
Hepatitis B series – 3 shots given over 6 months (may be completed at college with prior notice)
Recommended by the Institution:
Varicella – to be considered by persons who have never had chickenpox
Meningitis – (Menomune or Menactra) This should be discussed with the health care provider. An information sheet is included in the Admissions packet.
1. Where can I get my records? High schools, military services, family doctors, baby books and prior colleges attended.
2. What if I can’t find any records? The mandatory shots will have to be repeated or blood tests performed to check for immunity.
3. What if I object to getting shots? Unless there is a physician-documented medical reason or documented religious exemption acceptable to the state, you will be required to comply before starting classes.
4. Can I get my shots at college? Yes, the costs are outlined below.
MMR $67 Tetanus $30-50 TB test $17
Hepatitis B $20-$70 (depending on dose)
Varicella (special order)
Meningitis $190 (pre-payment required/special order)
Flu shot $12-$15 (offered annually each October; price may change)
4. What if I can’t afford the mandatory and required shots? Arrangements can be made to receive them through your County Health Department or through Madison County for $24 once at college. Some vaccines are not available through the county programs.
Health insurance is required of all full-time students attending Cazenovia College. An online waiver form must be completed before July 31, or January 29 for January entrants.
A basic Student Plan is offered through the College and students will receive enrollment information by May 1. The cost is $1,537 for the 2015-16 year for August entrants. The fees are pro-rated for January entrants for coverage from January 1 - August 17, 2016. Brochures are available from the Health Office or on the company's website at https://www.gallagherstudent.com/cazenovia. Click on My Benefits and Plan Information from the menu on the left to download the brochures.
1. Will my own insurance cover me at college? Probably, but there may be restrictions. You should call the insurance company directly. Many companies require proof of enrollment as a full-time student. A letter is available from the Registrar once classes begin. Kinney Drugs is adjacent to campus and Rite Aid is 3/4 of a mile away.
2. What if I can’t afford health insurance? The College offers a basic option or students may call their county Social Services office about Medicaid or other supported health plans. Child or Family Health Plus may be another option for NY residents. The phone # is 1.800.698.4543. You may go to http://www.healthbenefitexchange.ny.gov/ for information on New York State’s health insurance marketplace (state exchange).
The Health Center is open 7 days a week during the busy academic year.
1. What if I get sick or hurt after the Health Center is closed? If a medical emergency occurs after hours, Security, Athletic or Residence Life staff will assist with arrangements. CAVAC is Cazenovia’s local ambulance service located 1 mile from campus. For non-emergency medical needs occurring after hours, Security, Athletics or Residence Life staff will assist the student in making a decision about seeking care. Staff may consult with the nurse practitioner on call.
Students may receive allergy shots for a nominal charge at the Health Center. This service is offered based on thorough medical information being provided and a form signed by the student agreeing to the protocol.
1. Am I eligible to get allergy shots at the Health Center? Most likely all students will be eligible to receive this service, however, complicated or unclear medical regimens, allergist orders for a medical doctor to be present, history of severe reaction, or non-compliance with office policies may be reasons for referral to an off-campus provider at the student’s expense. Full documentation and consent forms for injections must accompany the serum and students should contact the Health Center as soon as possible to make arrangements. The fee is $5/visit.
1. Is there a charge to see a nurse at the Health Center? No. Unlimited office visits are provided to see the RN or Nurse Practitioner regardless of insurance coverage. Additional charges may be incurred if lab testing, vaccines or prescriptions are warranted. Annual GYN office visits have a co-pay of $5. All fees are discussed with students prior to services being rendered. A schedule of fees is posted in the office.
Health records of all patients are protected by law. Patients 18 and older must provide written authorization for information to be released. (Authorization by phone may be permissible in cases not involving records release). Restrictions on release of information may apply to minors in some cases.
1. Can my parents or teachers get information about me if they call? No, unless permission has been given by the student. If a parent calls the office, every attempt will be made to contact the student for permission, which will be noted in the medical record. In the event of serious or life-threatening conditions, staff may notify a parent or guardian.
The Health Center provides fax and phone access for release or transfer of health information. There is no charge for this service.
1. How do I get my records transferred to or from another school/provider? A written authorization is required to transfer or relay health information to other providers, agencies, schools or school administrators. Release forms must be signed by the patient in all cases unless under 18 where parent signature is required.
All questions and requests for information can be directed to the Health Service staff by calling 315-655-7122 or 315-655-7207. Voice mail is available. The fax # is 315-655-4724.
Regular academic year hours:
Monday – Friday: 8:30 a.m. - 5 p.m.
Sat. - Sun.: 2 p.m. - 5 p.m.
Breaks and summer hours:
Monday – Friday: 9 a.m. - Noon
Director: Susan Berger, EdD, ANP, Nurse Practitioner
Nurse Practitioner: Kate Dolan, MS, FNP
Staff Nurse: Kathy Same, MS, RN
Weekend Staff Nurses: Cindy Irvin, RN/Sheila McGuire, RN, NP/Robyn Bushneck, RN
Medical Secretary: Lynne Joncas, AAS