of Immunization Form and Instructions
From the 2013-2014 Catalog
Connecticut General Statutes Section 10a – 155.
Beginning August 1, 2010, all incoming freshman are required to show proof of Measles, Mumps, Rubella, Varicella immunization.
STUDENTS ARE EXEMPT from showing proof if:
born before January 1, 1957
taking online courses only
part-time not matriculated
Official Documents include:
Physician's documentation of inoculations.
Blood work indicating immunity.
A physician's certification that the student had the disease.
A physician's certification that inoculation is medically contraindicated.
A signed statement that receiving immunizations is against your religious beliefs.
The first Measles, Mumps, Rubella, and Varicella inoculation must be after the student's first birthday. A second MMRV inoculation is required and must be at least thirty days after the first.
Documentation must be submitted before registration A Proof of Immunization form may be downloaded from the Admissions section of the HCC web site at www.housatonic.edu and submitted along with your application for admission.
For more information call 203-332-5097 or 203-332-5062 or fax information to 203-332-5063.
The Admissions Office assists anyone needing further program information.
A personal interview is optional, and those who wish may make an interview
appointment by contacting the Admissions Office at 203-332-5100 or Email