Health and Immunisation Forms

As stated in the conditional offer, you must be immunised for personal and/or public protection and provide relevant information on immunisation status. You must also complete a Health Declaration Quesionnaire and be assessed as satisfactory by the Occupational Health Service. 

The Health Declaration (PDF - 112KB) and Immunisation form (PDF - 80KB) must be completed and returned to As part of the condition the forms must be returned to the email address by 31st May 2019.

We look forward to receiving your Health and Immunication forms by the stated deadline. Further information regarding these forms is available below.

Please also take the time to read the Occupational Health (OH) department of the UHB NHS Trust's privacy notice relating to the handling of this sensitive data (PDF - 364KB).

Pre Course Health Questionnaire

The information you disclose in this questionnaire will remain confidential to the Occupational Health Department and will be used only to assess your fitness for your proposed course. You will be responsible for disclosing medical information to the University, reasonable adjustments may be made by the University for medical conditions and/or disabilities.

Your Course Tutor and the Admissions Office will only receive an opinion as to your fitness for the course.  The information you give will be stored on the dedicated Occupational Health electronic record system and will be treated in strictest confidence by the Occupational Health Department in compliance with data protection law unless explicit consent is given for further disclosure.  In accordance with this Act, you may have access to your records at any reasonable time.  If you require a copy of any part of your record, this will only be supplied upon written request, which may incur a cost.  In some cases, it may be necessary to ask you to attend a health interview.

Immunisation History Record

  • All students on courses which have a clinical component must have been immunised against Rubella, Measles and Tuberculosis.
  • You are advised to commence a full course of Hepatitis B vaccinations.  If the course is completed a Hepatitis B Surface Antibody blood test is also advised.  This immunisation/testing schedule is necessary for Dental Surgery and Dental Hygiene and Therapy students and should be undertaken prior to admission.
  • Dental students additionally require validated blood tests for HIV Screen, Hepatitis C Antibody Screen and Hepatitis B Surface Antigen. 

You may consult with your GP to complete the Immunisation History Record, but they are not obligated to do so.  Below are examples of websites that can be used as a resource:


MASTA Travel Clinic

Please send copies of documentary evidence.  Do not send originals. 

We would recommend you retain copies of all completed forms for your own records.

You will only be contacted if there is a need for clarification with your health clearance.

Please return the completed health declaration (PDF - 112KB) and immunisation record (PDF - 80KB) to This must be received no later than 31 May 2019