State of Hawai'i Health Clearance Requirements

State of Hawai‘i Health Clearance Requirements

State of Hawai‘i law mandates that certain health requirements be cleared before students can enter into postsecondary institutions (Hawai‘i Administrative Rules, Title 11, Department of Health, Chapter 157 Examination and Immunization) which may be found here. The following information is provided to assist students with fulfilling these requirements prior to beginning classes at HPU.

Students may submit proof of appointment if they are unable to comply with these requirements before the start of classes.

Required of all students who will be taking their first courses at HPU on or after July 1, 2020:

  • Tuberculosis and Measles, Mumps, Rubella FORM D
  • Tetanus-Diphtheria-Acceular Pertussis, Varicella, and Meningococcal Conjugate FORM E

It is preferred that students print and bring both forms to their medical provider.  The medical practitioner will review the requirements, enter the required information, and sign each form.  Note that forms must be completed by a US licensed practitioner.  A US licensed practitioner signed record of immunizations (and any supporting documentation) may be submitted in lieu of Forms D and E.

International students submitting forms requesting a U.S. State & License Number can be left blank upon submission if you are located outside of the U.S. The original documents must be signed upon arrival to HPU. This can be done at HPU’s Health Clinic.

Hawai’i Pacific University has partnered with Med+Proctor for the submission of immunization records.

International Students:

  1. Only email your HEALTH INSURANCE WAIVER FORM (Form A and B) to the Office of International Students and Scholars (OISS) at iss@hpu.edu. 
  2. Immunization records (Form D and E) such as MMR, VARICELLA, TB, ETC. must be uploaded to Med+Proctor. All other documents will be rejected. 

Please use the following instructions to create your Med+Proctor account:

  1. Ensure you have been admitted and have an HPU ID number before completing this process.
  2. Use the single sign-on link in your MyHPU Portal or click here to register for an account in Med+Proctor.
  3. You will have the option to:
    1. Directly upload your personal immunization records (any type of immunization verification will work). Note that documents can be uploaded from your phone/tablet, or computer), OR
    2. Download and print the Immunization Verification and Tuberculosis Clearance Forms.
      • Have a licensed medical provider complete and Form D and Form E. (A licensed provider can sign the form; it does not have to be the provider who originally vaccinated you.)
      • Once your form has been completed and signed by a health care provider, upload it to Med+Proctor.
    3. Click here for step-by-step assistance with uploading your medical documents to Med+Proctor.
  1. You will receive an email from Med+Proctor within 7 to 14 business days letting you know if the immunization requirements have been met. Non-compliant submissions will require additional time to process.
  2. For questions/support related to the submission/verification process, please contact Med+Proctor at help@medproctor.com OR use the chat icon at the bottom right corner of your screen (once logged to Med+Proctor). Please note that Med+Proctor office hours are 9 a.m. to 5 p.m. Central Time.
  3. Be sure to check your HPU student email or your “Immunization Status” in your MyHPU for all verification updates from Med+Proctor.

**Note: Student may opt in to a Med+Proctor membership for a one-time fee of $10.  Membership provides lifetime access to your TB and immunization data.  You do not need to pay for Med+Proctor services. If you do not wish to take advantage of the membership, when asked to submit your records, choose the grey button at the bottom, which says “No, thank you. I do not want access to my documents.”

Med+Proctor is HIPAA and FERPA compliant. Review their privacy policy. For assistance with Med+Proctor, please visit support.medproctor.com to live chat or email at help@medproctor.com and they will speak directly with you. Due to federal FERPA and HIPAA regulations Med+Proctor does not offer telephone customer support to discuss student medical records or class hold status. 

Please note that these requirements apply to all HPU students (including faculty and staff who are students) and are separate from the additional records required for students in certain health science programs (including Nursing, DPT, and other programs) as well as the School of Education.  These programs may have additional vaccination requirements due to third party requirements for practicum, clinical, or internship placements, and students should consult with their programs and/or the program student handbook for specific requirements. Students who wish to apply for any exemptions to vaccinations that are required by specific academic programs should complete this form. You may not register for classes until you have received health clearance from HPU Health Services.

Final review of all medical documentation is completed by HPU Health Clinic Staff.

 

Post-Secondary School Students are Required to Have:

U.S. AND STUDENTS COMING FROM FOREIGN COUNTRIES:

 

 

  • 2 doses of measles vaccine are required, with at least one of the two being an MMR (Measles, Mumps, and Rubella) vaccine. 
    • 1st dose must have been given on or after 12 months of age.
    • 2nd dose must have been given at least 4 weeks after the first dose.
  • Lab results and reference ranges must be submitted for titer shots.

EXEMPTIONS:

 

 

  • Student was born before 1957 (must provide proof of birth date).
  • Laboratory evidence of immunity (positive antibodies) to Measles and/or Rubella. Please note that the State of Hawaii Department of Health does not accept serologic test results for Mumps immunity. 

 

Post-Secondary School Students are Required to Have:

U.S. and STUDENTS coming from foreign countries:

 

 

  • A completed TB Risk Assessment Form (such as the State of Hawaii Department TB Risk Assessment Form)
    • This form must be completed within 12 months of starting at HPU or must have been completed on or after the age of 16.
  • IF the Risk Assessment Form presents risks, one of the following is required:
    • A negative Tuberculin skin test (PPD-Mantoux). The skin test must be read 48-72 hours after administration and documented in millimeters (mm). Test results without the induration in millimeters will be rejected.  
    • A negative QuantiFERON Gold In-Tube or T-Spot Blood Test.
    • A negative chest x-ray (taken within the last 12 months) with laboratory report/results attached.

NOTES:

 

EXEMPTIONS:

 

  • Not required if the planned course is less than 120 days.
  • If the student is never physically on campus for instruction or training.

 

 

A TB clearance may be obtained from any of the following:

Post-Secondary School Students are Required to Have:

 

U.S. AND STUDENTS COMING FROM FOREIGN COUNTRIES:

 

 

  • 2 doses of varicella vaccine are required.
    • 1st dose must be given after the age of 12 months.
    • 2nd dose must have been given 4 weeks after 1st dose (for students who received 1st dose at age 13 years or older).

 

EXEMPTIONS:

 

 

  • Students born in the United States prior to 1980 (Must provide proof of date of birth).
  • A signed, documented diagnosis or verification of a history of varicella disease or herpes zoster by a practitioner may be substituted for a record of varicella vaccination. Practitioners may complete this form to confirm the documented diagnosis.

Post-Secondary School Students are Required to Have:

 

U.S. AND STUDENTS COMING FROM FOREIGN COUNTRIES:

 
  • 1 dose required - most recent dose must have been given on or after the age of 16 years.
  • Note: Only required for new students planning to live on-campus who are 21 years of age or younger.

 

Post-Secondary School Students are Required to Have:

 

U.S. AND STUDENTS COMING FROM FOREIGN COUNTRIES:

 
  • 1 dose required – most recent Tdap.

Exemptions

Valid exemptions for MMR, Varicella, MCV, and TDAP immunizations include medical and/or religious reasons. No other exemptions are allowed by the state.

 

Medical exemptions must be obtained from the student’s healthcare professional (i.e. a doctor’s note) that includes the start date and the end date the student is no longer exempt. The student will need to comply once the exemption period has ended. The completed Medical Exemption Form should be sent to the State of Hawai‘i Department of Health (address on the form), with a copy sent to HPU at 1 Aloha Tower Drive, Honolulu, HI 96813.

 Medical Exemption Form - All Other Immunizations

 

If immunizations conflict with a student’s bona fide religious tenets and practices, students may request an exemption on religious grounds.

 Religious Exemption Form

The State of Hawai‘i does not provide religious or medical exemptions from the Tuberculosis Clearance requirement.

Any exceptions must be obtained from the student’s healthcare professional (i.e. a doctor’s note) that includes the start date and the end date the student is no longer exempt. The student will need to comply once the exemption period has ended.

All post-secondary students who attend classes exclusively online or electronically via remote learning are excluded from the immunization and TB Clearance requirements.