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Beloit College Health Forms and Required Vaccinations and Immunizations

Please read carefully, and complete, the Health Center materials which were enclosed with your letter of admission. If you cannot locate those materials, they can be viewed and printed out online at

Wisconsin state law requires proof that you have been vaccinated against various diseases. Please go to the Beloit College Health Center website at and print the Immunization/Vaccination form and take it to your home doctor to complete. The form must be completed in English.  All names and dates of vaccines must also be in English. If you have not received the required vaccines or provided laboratory proof of being immune you will be required to complete the immunization at Beloit College.  There will be a cost for these immunizations and a delay in your course registration.

You must have proof of your MMR (Measles, Mumps and Rubella) vaccines by either a laboratory filer and vaccination dates or it must be signed by a medical doctor.          


If you have not already filled out the form and returned it with your housing materials, you can mail it to the International Student Advisor, Shannon Jolly, by July 16th. I will make sure the Health Center receives them please keep a copy of your forms and bring it with you, just in case your forms are lost in the mail.You will not be able to register for classes if your forms are incomplete or missing. You can also scan and e-mail the documents to me but bring the originals.

Wisconsin state law requires that you read the information included with your health form about the diseases Hepatitis B  and Meningitis. You must sign and complete the form confirming that you have read the information.

Diptheria/Tetanus vaccinations should be within the last 10 years. If not, please update before coming.

Beloit College requires you to have completed a physical examination before coming to campus.

The state of Wisconsin and many infectious disease authorities recommend that college students consider vaccinations against Hepatitis B, meningitis, and chicken pox. If you are interested, you may receive the vaccine at the Health Center on campus at a cost. For more information about these diseases and the vaccines, go to the Center for Disease Control and Prevention website  

For more information on what the Health Center at Beloit College can offer and more information about specific forms, please go to their website, which is:

When you are filling out your health forms, it will ask for your insurance information. As an international student you are enrolled in the Student Assurance Services plan. Here is the information you need:

Student Assurance Services, Inc.   (Insurance Company's name)
Master Policy #48-64-0152-521-665-8  (Policy Number)

IF YOU ARE AN ISEP STUDENT:  You are under the following insurance:

BCS Insurance Company (Insurance Company’s name) Master Policy #IES-00002

If you have any questions concerning state and university requirements for immunization information, please send your questions to me. If these forms are not complete there will be a hold on your account and you will not be able to register for classes.