Health Clearance Form
The Health Clearance Form documents your immunization history and completed health requirements. The Health Clearance form can only be obtained from CSUB Student Health Services. The Department of Nursing will only accept the ORIGINAL COPY of the health clearance form.
The health history, physical examination, and health questionnaire forms need to be submitted to the CSUB Student Health Services in order to obtain your original copy of the health clearance form. You may use your own personal physician or CSUB Student Health Services. Get the full health history, physical examination, HIPPA, and the health questionnaire forms here. These forms need to be used if you are using your personal physician.
If you wish to use the CSUB Student Health Services for your physical examination, please call them at (661) 654-2394 to schedule an appointment. Please keep in mind that that the student health center uses a 2 step TB clearance process which can take approximately 2 weeks to complete. You need to schedule your appointment well in advance of your mandatory orientation date.
If you are not enrolled in courses at CSUB the quarter before you begin the nursing program, there will be a $15 additional charge for the Health Clearance and/or physical exam. CSUB Student Health Services fees can be found at http://www.csub.edu/healthcenter/fees.shtml.