All new students entering UW–Madison must complete an Immunization and Health History Form. The information you provide is confidential and will be retained by UHS as part of a student’s medical record. This information is valuable to students as they receive health care throughout their UW–Madison career. The Immunization and Health History Form is only available online through a student’s MyUHS account.
Examples of the Immunization and Health History Forms
- Log in to MyUHS and select “Forms” in the left column. Complete all three forms. Enter the dates to the best of your ability. If you recall that you received a vaccine in the spring of 2005, then enter “3/1/2005”.
- Do not use the “Enter” key while filling out the form due to limitations of the web application.
- Once you click “Proceed” to submit a part of the form, you will not be able to make changes.
- Print a copy for your records before submitting each form.
If you have questions regarding the forms, email firstname.lastname@example.org.
To check your Wisconsin immunization record, visit the Wisconsin Immunization Registry.