Medical History Form
Resident students must complete this medical history form with the assistance of a physician prior to arrival at LVC.
All new students are required to complete the New Student Medical History form which can be found in the Admission portal as well as online, at the health services webpage. The physical exam portion must be completed no earlier than one year prior to your arrival to LVC. The physical exam is a good opportunity to review all required immunizations with your doctor.
Please have all immunizations completed prior to your arrival to LVC. Routine immunizations are not available at the college.
LVC requires the following immunizations (listed on the Medical History form):
- Tuberculosis Testing (PPD skin test) within the past 12 months (IGRA/Quantiferon gold blood test is acceptable and is recommended for those who have had BCG injection)
- TDAP/Adacel/Boostrix (within last 10 years)
- OPV (polio) series
- MMR (2 doses required OR separate measles, mumps, rubella injections are acceptable)
- Varivax vaccine (2 doses required) OR proof of Varicella disease (provide date/age)
- Meningococcal (Menactra (A/C/Y/W-135) (if first dose before age 16, second dose required)
- Hepatitis B (series of three)
Titers are acceptable for the following:
- Measles, mumps, rubella
- Hepatitis B
The following immunizations are recommended, but not required:
- Hepatitis A
- Meningitis B
If you have any of the following conditions, please take the time to fill out the form(s) that is most relevant for you:
Health Insurance Coverage
Lebanon Valley College requires all residential international students to maintain medical insurance that provides coverage in the United States. Therefore, enrollment in the Lebanon Valley College-sponsored health insurance plan is automatic and the cost of the policy is included in the student’s tuition and fees invoice. In certain cases, students holding comparable insurance policy coverage may be eligible to waive enrollment in the LVC's health insurance plan. In addition to personal health insurance coverage, the comparable plan must include the following benefits and minimum limits in order to be considered for an exemption:
|International Students Attending Classes at Lebanon Valley College|
|$100,000||Can be included in personal health insurance if coverage extends to care in the United States.|
Additionally, students will provide evidence that the comparable policy has a health insurance claims office based in the United States. Students requesting a waiver review of their individual insurance policy should submit the following information to firstname.lastname@example.org by Aug. 1 for the fall semester and Dec. 1 for spring semester:
- Insurance company name
- Insurance company phone number and claims address
- Policy number
- Policyholder name and date of birth
- Photocopy of policyholder ID (if already purchased)
- Detailed list of coverage benefits. The detailed list should be specific to your individual plan. A generic list from the insurance company’s website is insufficient. Please contact your insurance directly to obtain your detailed list of coverage.
After review and acceptance of your submitted waiver form, your Lebanon Valley College tuition invoice will be credited with the automatic policy premium. Please note that the waiver request must be renewed every academic year.