St. Ambrose University, Davenport, Iowa

Health Service Checklist

The staff from the Student Health Services office would like to provide this information for your consideration. The purpose of this checklist is to help students plan ahead and come to campus not only with what is required by university policy, but also with items needed to avoid illness or to help in case of illness. Please review this information and bring the following items with you.

1. Health Form: A properly completed Health Form is required to be provided to the Health Services' staff prior to beginning any course of study. The health form provides the office with a student's demographic information, medical history, physical exam, dates of immunizations and health insurance information. The Health Form can be accessed and printed from this link.

This information is confidential and will not be released without the student’s permission . Permission to share information will be requested in particular for student athletes and those students in a program of study requiring a clinical rotation or other practicum experience. Additional physicals and other tests or immunizations will likely be required.

Immunizations: The Advisory Committee on Immunization Practices (ACIP) and the American College Health Association (ACHA) recommend the following vaccinations. All of these are usually required for students in health sciences or other programs requiring clinical rotations or other practicum experiences. Additional information is available on our website listed above.

MMR (measles, mumps and rubella): Two doses at least 28 days apart if born after 1956.
Varicella (chickenpox): Two doses at least 28 days apart if you never had the chickenpox or a blood test does not show immunity.
Hepatitis B: Series of three doses (This immunization or a declination is often required for a clinical rotation or practicum.)
Tetanus (Td or Tdap): Booster at 11-12 years of age and Td booster every 10 years.
Meningococcal Tetravalent (meningitis vaccine): Required to have vaccine or to complete the Declination of Meningitis Immunization page that is part of the Health Form. Additional information is available on our meningitis link.
TB (Tuberculosis) Screening: For high risk students, international students, health science students or other students with clinical rotations or practicum or students displaying symptoms of illness. A two-step test followed by annual one-step tests is usually required for health science students and others with clinical rotations or practicum experiences.

2. Health Insurance Card: Proof of current health insurance is required. If you do not have insurance, you may seek it through Health Services. Keep a personal health insurance card in your wallet. Review your policy so that you understand your coverage, co-payments and prescription plan. Check the policy to be sure that you are covered for "out of area" non-emergencies.

3. First Aid Kit: Consider keeping a kit and filling it with a box of Band-Aids, an ice pack, hand sanitizer, antibiotic ointment, hydrocortisone cream, alcohol pads, disposable thermometers, a small flashlight, acetaminophen, ibuprofen, throat lozenges, an epipen (if indicated for severe allergies), bottled water and sports drinks. Refill as needed.

4. Humidifier: Consider one to provide moisture in dry dorm room to help prevent sore throats and congestion.

5. Air conditioner: For persons who have a history of allergies or other health conditions and are assigned housing without air conditioning. Please provide a doctor's note regarding the need for air conditioning in these limited circumstances.

6. Prescription Medications: Bring a month's supply of any ongoing medications which can be kept in your dorm room. Plan ahead and bring a refill prescription with you from your health care provider. There are two pharmacies within walking distance from campus.

7. Special Needs: For special needs, or if you have any questions, please contact Nancy Hines, MS, RN in Health Services at 563/333-6423 or via e-mail at HinesNancyA@sau.edu.

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