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Mandatory Health Record Form

All new graduate students must submit the completed Health Record Form (provided here as a pdf) to the Syracuse University Health Services before registering for your first semester.

Download, print, and mail the health record form to:

SU Health Services
111 Waverly Avenue
Syracuse, NY 13244-2320
phone: 315.443.2666
fax: 315.443.9010

In particular, you must fill in the immunization information on part 3 of the health form. If your immunization information is not provided, your registration may be delayed. Mail this form prior to arriving on campus. Do not forget to sign the form.

Students born after January 1, 1957 must submit documentation of the following immunizations administered after 12 months of age:

  • 2 doses of measles vaccine;
  • 1 dose of mumps vaccine; and
  • 1 dose of rubella vaccine.

Other medical records must also be provided. If you do not provide this information by the middle of your first month on campus, you may face suspension from the University. Further information may be obtained from SU Health Services.

Required Health Fee and Health Services

There is a mandatory Health Service Fee for all full-time, matriculated graduate students. Payment of the fee entitles students to health services in the clinics of the SU Health Center. The cost of support services such as x-rays, selected procedures, medications, and hospital suplies are in addition to the health fee, although often at savings to students.Part-time students may choose to pay the health fee for the same coverage or pay per office visit. Eligible spouses and part-time students are charged an office visit fee when services are provided.

Graduate students who hold assistantships or associateships will receive a health fee remission. This fee is also remitted for students who hold Graduate Fellowships or full-tuition Scholarships that provide them with 12 or more credits of tuition per semester.

Health Insurance

It is strongly recommended that students carry health insurance to cover expenses not covered by the health fee and medical expenses incurred outside the health center, such as emergency room care, hospitalization, eye care, and dental services.

International students are required to show proof they have health insurance for themselves and their families throughout their stay in the United States.See our health matters section for all health-related requirements.

University Fellows, graduate assistants, and graduate associates are eligible to participate in the University's Group Health Care Plan. Coverage details and premium rates can be found at the Office of Human Resources, Employee Benefits.

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The Graduate School • 207 Bowne Hall • Syracuse, NY 13244 • 315.443.2543
Graduate Enrollment Management Center • 303 Bowne Hall • Syracuse, NY 13244 • 315.443.4492
Grad@syr.edu