Immunizations and Medical History

All incoming students are required to complete a paper form and an on-line form.

If you were previously an undergraduate or graduate student at the University of Delaware and previously submitted immunization and medical history information, please contact us so that we can check and see if the information you have on file meets current requirements. Please be sure to include your full name and University of Delaware ID Number. If you do not know this number, please tell us your date of birth.

The paper form requests immunization information and other basic information including a consent to treat from a parent or guardian if you will be under 18 when you arrive on campus. Please note that this form needs to be signed by a health care provider (a physician, nurse practitioner, physician assistant or nurse). This form can be accessed and printed below:

Immunization Information Form

This form should be scanned in and uploaded to our secure web server. Log in at

Scan the form onto your computer. Please be sure that when you scan the top of the form is on the top of the screen so that the form is not upside down.

Select Immunization Upload and follow the instructions

If you are unable to scan the form and upload it, the form can be mailed to:

University of Delaware
Student Health Service
Newark, Delaware 19716-8101

or faxed to (302) 831-6407.

The online form regarding your medical history can be accessed and completed by logging onto the Student Health secure server at:

Please note that to log on to the Student Health secure server, you need to enter either your UDelNetID (username) and Password or your UD ID (usually a nine digit number beginning with 7) and your Pin.  If you are an incoming undergraduate student and your University of Delaware accounts are not yet activated, please do so at the following site:

If you are a new undergraduate student and still have difficulty setting up your University of Delaware account, please contact

If you are an incoming graduate student and your University of Delaware accounts are not yet activated, please refer to your admission letter that gives the instructions for the setting up of your UD accounts.

If you successfully log on and get the following message

We apologize, but we were unable to locate your record. Please contact the health center.

Or if you get a message that your date of birth does not match please contact Student Health using the following Contact Form:

After entering your date of birth, select forms on the left to complete the medical history form.

If you are a new student and do not see the on-line forms, please contact Student Health at

Please note that we are required to prevent you from registering for your second semester if both the paper form and the on-line form are not completed.

If you have any difficulty, please Student Health at: