To be signed by your health care provider and returned to Lauren Tokash at ltokash@marywood.edu.

To be completed and signed by your health care provider and uploaded to your Student Health Portal. Make sure to complete this ASAP in case you need updated immunizations prior to starting program in May.

Marywood History and Physical Form (with the following requirements):

2 Step PPD (Tuberculin skin test) or an annual PPD with history of 2 Step

Immunization history consisting of: Completed Hepatitis B series, Polio series, Completed DTP series, Tdap within 10 years, and annual Influenza vaccine (due every November). While the COVID-19 vaccine is not a requirement of Marywood University, PA students cannot be placed in community activities or clinical rotations without being fully vaccinated. If students are unable to fulfill required portions of the program, including clinical rotations and other activities, they will not be able to graduate.

Titers: Blood work identifying your immunity to disease. The titers that are required by our clinical sites include Measles, Mumps, Rubella, and Varicella IgG titers. The MU History&Physical form does not note the titer requirement, so make sure to tell your health care provider that you also need bloodwork titers for the above diseases. Submit the results to your student health portal. Please make sure to complete your titers early to ensure lab results are available to be sent and received by Student Health prior to May 1, 2023.

To be completed, including a photo, and returned to Lauren Tokash at ltokash@marywood.edu

If you have accrued additional healthcare hours since your interview, please list the total/type here. Please return to Lauren Tokash at ltokash@marywood.edu

Send to Lauren Tokash at ltokash@marywood.edu

Send to Lauren Tokash at ltokash@marywood.edu

If you do not have health insurance, Marywood does offer coverage to enrolled students. You can apply here.

If not on official transcripts. Send to Lauren Tokash at ltokash@marywood.edu if not included in your interview paperwork.

Send to Lauren Tokash at ltokash@marywood.edu if not included in your interview paperwork.

Only required if there have been changes/new courses, taken outside of MU, since your interview date. We do not need transcripts from Marywood as we already have access to those. Send transcripts to Lauren Tokash at ltokash@marywood.edu.