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Health and Immunization Requirements for International Summer Program Participants

PLEASE NOTE: This information is for International Summer Program Participants Only. International Students attending for at least one semester are required to complete the Health History/Physical and Immunization Form.

Welcome to SUNY Canton! My name is Patty Todd and I am the Director of SUNY Canton’s Davis Health Center. All of the staff at the Health Center hope that your time here will be enjoyable, educational and healthy.

In order to participate in our summer program, you must complete the International Summer Participant Health and Immunization Form. This is a mandatory form which includes vaccinations that are required by law in order to reside on the college campus. You will not be allowed to come to SUNY Canton without completing and submitting the form. This form must be submitted four (4) weeks before your arrival on campus. You can have your provider complete the form in your native language and transcribe it to the English version and send both versions. Forms should be converted to a PDF and sent electronically as an attachment.


The Health Form has Four (4) Parts that need to be completed!

International Summer Participant Health and Immunization Form PDF Download Adobe Reader here

Part I and II: Immunization and Tuberculosis Questions
Print the downloaded form and have your healthcare provider complete the immunization being sure that all the sections are completed and signed by your healthcare provider. The tuberculosis screening section includes questions that you can answer and don’t need a doctor.

Part III: Complete your personal health information making sure you answer all the questions in the section.

Part IV: Parental Consent for treatment section is only required for those who are under 18 years age.

You can have your provider complete the form in your native language and transcribe it to the English version but you must send both versions. Forms should be converted to a PDF and sent electronically as an attachment to toddpa@canton.edu. You are finished with the Health Requirements. I look forward to meeting you!