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Allied Health Professionals Health History Form
Allied Health Professionals Health History Form

Per CMH policy-students participating in clinical education will need to fill out the "Health History Form" prior to beginning the educational experience.

For students participating/observing in patient care areas:

  • History of chickenpox disease
  • History of rubella, titer, or last MMR vaccine given after 1980
  • Result of last TB skin test (which must be within the last 12 month period)
  • Status of Hepatities B vaccination

For students participating/observing in non-patient care areas:

  • History of chickenpox disease
  • History of rubella, titer, or last MMR vaccine given after 1980
  • Result of last TB skin test (which must be within the last 12 month period)

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