Harvard University Health Services

Graduate School of Arts and Sciences (GSAS)

Please print and complete all required forms below.
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Mail to address shown on form.

You must also provide this address to your physician to send your completed Certificate of Immunization and Physician Report.

If you have questions or need to request printed forms, please contact your Immunization Coordinator at 617-495-0542.


Deadlines
Fall Term Students: July 15, 2009
Spring Term Students: January 9, 2010

Incomplete or overdue forms may delay registration

Note: Hepatitis B immunizations require a series of three injections over a six-month period. Students who are not yet immunized against Hepatitis B are expected to complete at least two injections prior to registration.