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Non-Employee Health Portal

  • Use this page for submission of non-employee vaccinations, TB screening and health history documents.
  • For questions regarding the two-step TB skin process, titers or other health requirements, please visit the FAQs (PDF).
  • The health requirements are to be met at your own expense.
  • Provide documentation for these vaccines and TB screening at least two weeks before the start date.

Please complete the form below.

* - Required Fields

First Name:* 
Last Name* 
Middle Name (if applicable):
Other name used (AKA, prior or maiden name):
Birthdate*  
ID Number (if applicable):

Vaccination Requirements for All Contractors

Influenza Vaccine
(1 dose annually if working October 1-March 31)

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Varicella (VAR) Vaccine
(2 doses or positive antibody titer)

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Measles, Mumps, and Rubella (MMR) Vaccine
(2 doses or positive antibody titer)

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Tetanus, Diphtheria and Acellular Pertussis (TDap) Vaccine
(1 one-time dose of Tdap vaccine. If Tdap more than 10 years ago, also need tetanus/diphtheria booster within 10 years.)

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Hepatitis B Vaccination Requirements

(Only required for individuals who perform tasks that may involve exposure to blood or body fluids.)
Hepatitis B (HepB) Vaccine
(3 doses of the hepatitis B vaccine and positive titer OR hepatitis B declination form if not vaccinated and not desiring hepatitis B immunization)

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Meningococcal Vaccine

(Only required for microbiologists who are routinely exposed to isolates of Neisseria meningitidis. Both MenACWY and Meningitis B vaccines are required for these individuals.)
MenACWY vaccine:
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Meningitis B vaccine:
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Tuberculosis (TB) screening

Typical TB Requirements for New Applicants: (See below for exceptional circumstances.)
A baseline two-step TB skin test OR a TB blood test. (Must be performed 0-30 days prior to the UMMC start date. If documentation of a TB skin test completed within the past 12 months is provided, then only one TB skin test is required 0-30 days prior to UMMC start date.)
Tuberculosis (TB) Verification:
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TB Requirements for Renewal Applicants
Complete and submit TB risk assessment form. Student and Employee Health staff will review and notify whether additional TB documentation is needed.
TB Risk Assessment:
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Exceptional circumstances

  • New Applicants who are Prior BCG (TB) vaccine recipients:

    TB blood test within 30 days of UMMC start date. If blood test is positive, submit a chest x-ray report within 30 days of UMMC start date.
  • New applicants who are international arrivals to the U.S. within the past 5 years:

    TB (IGRA) blood test and a chest X-ray within 30 days of UMMC start date if from the countries with a high TB burden.

    Please click here for the list of countries.

    If you are not from any of the countries listed above, complete a TB blood test. If the test is positive, a chest X-ray is required.
  • New applicants with a prior positive TB screening test or TB disease:

    Prior Latent TB infection: Submit a copy of the positive TB test report, a copy of the most recent chest X-ray report and a treatment card, if medication was received.

    Prior TB disease: Submit the proof of treatment, a completed pulmonary history form and a clearance certificate or letter by the treating agency or a healthcare professional.
 
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Educational Observers who will observe for 3 days or less should complete and submit a TB Screening Form. Student and Employee Health Staff will review this form to determine if TB test is required.
 
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