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Do I need to fill out a Health History Evaluation and Vaccination History Form?

All SIUE faculty, staff, and students who have, or plan to have, regular contact with live vertebrate laboratory or wild animals, must complete a medical history evaluation, including immunization history.  

The majority of Part A should be filled out by your physician after they have reviewed the Part B form that you filled out. ONLY Part A will be returned to our office.  

It may be beneficial to bring the Letter of Explanation to your physician, so they are clear on what is needed during the appointment.  

All these forms can be found on our website here 

A common misconception with the health history form is that the vaccination declination form can be filled out and turned in, in place of the health history. This isn’t accurate. A health history form must be completed regardless of vaccination status. The vaccination declination form is only used once your health care provider has conducted their assessment, recommended a vaccine based on the animals involved, etc. It’s only after the health history form has been completed by a health care provider can someone formally refuse the recommended immunizations.   

If you already have a health history on file with our office, please feel free to reach out and we can let you know when it will be expiring.  

For any question, please contact researchcompliance@siue.edu.