Compliance Forms

CNHP Immunization Record and Physical Examination Form

CNHP students must upload a completed CNHP Immunization Record and Physical Examination Form to DrexelOne AND their CastleBranch profile.

PLEASE NOTE: Behavioral Health Counseling, Health Services Administration, Health Sciences, Human Nutrition and Nutrition and Foods students are not required to complete the 7-page CNHP Immunization Record and Physical Examination Form. However, you will still need to complete University Immunization Requirements; more information can be found here.

Emergency Contact Form

Emergency Contact Form (PDF)
All students must submit contact information in the event of an emergency. This information must be kept current.

Seasonal Vaccines

Fall Influenza Form
This form must be completed and submitted by October 1st each year.

CNHP Seasonal Flu Policy for Students

In the United States, annual epidemics of influenza occur typically during late fall through early spring. Influenza viruses can cause disease among persons of any age group. Rates of serious illness, even death, are high among persons who have a medical condition that places them at increased risk for complications from influenza—the majority of those under treatment in health care facilities. Annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications. Influenza vaccine is recommended for all persons six months of age or older who do not have contraindications to the vaccination. Furthermore, routine vaccination of certain persons, including health care personnel, who serve as a source of influenza virus transmission might provide additional protection to persons at risk for influenza complications and reduce overall influenza burden. Consequently, annual vaccination is recommended for health care personnel, including persons in educational programs for health-care professions, and is a high priority for reducing morbidity associated with influenza in health care settings and for expanding influenza vaccine use. The health care personnel influenza coverage goal is set at 100% of employees who do not have medical contraindications; therefore, health care facilities will most likely mandate influenza vaccination during influenza season.

Drexel University students entering a health care facility during this influenza season must have the current influenza vaccination. The flu vaccine form is located at http://drexel.edu/cnhp/about/compliance/complianceForms/.

The completed Drexel CNHP flu vaccine form must be uploaded to the student’s CastleBranch document tracker at https://www.castlebranch.com. If the vaccination is not documented, students will not be permitted to participate in the clinical experience. This could affect the student’s degree course plan, program requirements, and time to degree completion. Supply of the influenza vaccine should be readily available. When vaccine is in short supply health care personnel are considered priority populations to receive the vaccine.

Students should avail themselves of the many sources of seasonal flu vaccine including their health care provider, retail pharmacy outlets, public health departments, community based flu clinics and the University’s Student Health Services center.

Source: Centers for Disease Control and Prevention http://www.cdc.gov/flu/professionals/acip/index.htm.

Tuberculosis Forms

If a student needs to complete a PPD after the submission of the completed physical exam and immunization documentation, please use one of the forms below:

Tuberculosis Form
Annual Tuberculosis Renewal Form - This form should ONLY be utilized to document an annual one-step PPD or to document an IGRA blood test.
Signs and Symptoms Form - A copy of CXR is required on file prior to beginning clinical, along with a Signs and Symptoms form; please note that an updated Signs and Symptoms form will need to be submitted annually.