All lab reports, doctor's notes, prescriptions and forms submitted to the Office of Health Services must include student's correct name and date of birth.
Click the link(s) below to retrieve the necessary form(s) and CUNY immunization requirements:
Student Immunization Record Form
Meningococcal Meningitis Vaccination Response Form
Measles, Mumps, and Rubella (MMR) opens in a new window
CUNY Immunization Requirements opens in a new window
Please email or fax the forms. You can send it to the Health Services email at [email protected] or the email of the Health Services representative who has contacted you with regards to your immunization records.
Email: [email protected]
Phone: (718) 631-6375
Fax: (718) 631-6330
You will need Acrobat Reader, or equivalent, to view all documents. Click the logo below for a free version of Acrobat Reader.
Referrals
Don't have health insurance? Want to know where you can get free vaccinations or lab reports on a sliding scale? You can contact the following places and find out more:
To get free vaccinations, please visit the Department of Health and Mental Hygiene (DOHMH) website opens in a new window or call 311 for clinic days, times and locations.
For lab reports:
Take Care New York
All New Yorkers without health insurance, including people who are undocumented, can receive primary health care from the Community Health Centers and Child and family Health Clinics listed…
At these places medical providers are not allowed to turn you away if you cannot pay for care or because of your immigration status. They offer a sliding fee scale based on family size and income (depending on your income, you may pay nothing).
These health centers and clinics help patients who qualify to apply for public health insurance programs.
Find out more on the NYC Care Website.
Queens
HHC: Child and Family Health Clinics (*MIC-Women's Health Services: provides prenatal and family planning services)
- Elmhurst Hospital Center, 79-01 Broadway, Queens, NY 11273, 718-334-4000
- Astoria Child Health Clinic, Astoria MIC Center*, 12-26 31st Avenue, Astoria, NY 11106, 718-334-6120
- Corona Child Health Clinic, 104-04 Corona Avenue, Corona, NY 11368, 718-334-6100
- Junction Boulevard Child Health Clinic, 34-33 Junction Boulevard, Jackson Heights, NY 11372, 718-334-6150
- Ridgewood Communicare Clinic, 769 Onderdonk Avenue, Ridgewood, NY 11385, 718-334-6190
- Medical Center at Sunnyside, 43-12 43rd Street, Sunnyside, NY 11104, 718-334-6230
- Woodside Houses Child Health Clinic, 50-53 Newtown Road, Woodside, NY 11377, 718-334-6140
- Queens Hospital Center, 82-68 164th Street, Jamaica, NY 11432, 718-883-3000
- Charles R. Drew Primary Care Center, 168-10 Archer Avenue, Jamaica, NY 11433, 718-883-5500
- Parsons Communicare Clinic, Jamaica MIC Center*, 90-37 Parsons Boulevard, Jamaica, NY 11432, 718-334-6440
- Jamaica MIC Center*, 90-04 161 Street, Jamaica, NY 11432, 718-523-2123
Community Health Centers
- Joseph P. Addabbo Family Health Center, 67-10 Rockaway Beach Blvd., Arverne, NY 11692, 718-634-2155
- Project Samaritan Health Services, Damian Family Health Care Center, 137-50 Jamaica Avenue, Jamaica, NY 11435, 718-298-5100
Students can also contact the Community Healthcare Network at the following locations:
Queens Health Center, 97-04 Sutphin Blvd., Jamaica, NY 11435, 718-657-7088
Services Provided:
- Adult medical care
- Adolescent health services
- Pediatric care
- HIV/AIDS medical care
- Prenatal care
- Family planning/Birth control
- Social work services
- HIV counseling and testing
- Dental services
- Other services
Please be advised you must call for an appointment first.
