Below please find a list of forms that may be useful to you in being in compliance with your immunization and Health Record requirements at Farmingdale State College.
Most commonly needed forms
- Health Record (pdf)
- Mental Health Referral Letter (pdf)
- Athletic Physical Exam and Clearance (pdf)
- Cardiac Athletic Questionnaire (pdf)
- Immunization Form (pdf)
- Meningitis Response and Information form (pdf)
- Patient Rights and Responsibilities (pdf)
- Student Immunization Policy (pdf)
There are a variety of ways you can submit your paper work.
- Mail: to Farmingdale State College- Attn: Health and Wellness Center
- Fax: 1-934-420-2137
- Drop off in person at the Health and Wellness Center. If the office is closed you can deposit your forms in a secure mailbox located at the front and rear entrances of the Health and Wellness building
Insurance Related Information
- Farmingdale State College is no longer offering a school sponsored insurance plan for the 2020-2021 Academic year.
- Visit https://nystateofhealth.ny.gov/ for information on New York State offered insurance plans.
- Release of Information (pdf)
- Measles, mumps, and rubella Vaccine Information Sheet (pdf)
- Tetanus-diphtheria Vaccine Information Sheet (pdf)
- Menactra (meningococcal) Vaccine Information Sheet (pdf)
- Gardasil (HPV) Vaccine Information Sheet (pdf)
- Seasonal Influenza Vaccine Information Sheet
- Tobacco Use Policy
Hours | Spring 2020
|Monday||8:30am - 6:00pm|
|Tuesday||8:30am - 7:30pm|
|Wednesday||8:30am - 6:00pm|
|Thursday||8:30am - 6:00pm|
|Friday||8:30am - 4:30pm|
During Recess Periods: Hours of Operation change to 8:30am-4:30pm daily.
Clinic Schedule for Spring 2020