Skip to Content Skip to Footer
Skyline sunset with WesternU sign
WesternU / Student/Employee Health / Health Clearance FAQs

Health Clearance FAQs

Health Clearance FAQS for Incoming Students

Please carefully read the details below regarding the documentation you must upload to your Castle Branch account in order to register for classes.

  1. Healthcare clearance by HealthCare Provider: must be within six (6) months of your first day of classes at WesternU).
  2. Serum blood titer reports: must be drawn within one (1) year of matriculation and show you are immune against measles, mumps, rubella, varicella and Hepatitis Immunization records and/or “had the disease” alone will not be accepted for these diseases. You must submit serum titer lab results that include reference ranges, along with your immunization records. These records must show, at minimum, your name, the name of the vaccine and the date of administration.
    • Hepatitis B (HbsAb, QN) [NOTE: only a QUANTITATIVE result will be accepted for this titer]
    • The following titers can be either Qualitative or Quantitative
      • Measles (Measles AB, IgG, EIA)
      • Mumps (Mumps AB, IgG)
      • Rubella (MMR AB, IgG)
      • Varicella (Varicella AB, IgG),
    • NOTE: The Student-Employee Health Office (SEHO) can provide you with a serum blood titers order/referral if you prefer to obtain the blood draw at any independent lab facilities (e.g., LabCorp, Quest Lab), other than your healthcare provider’s office. You may request the order by emailing us at
    • Serum blood titers are NOT the same as vaccinations/immunizations.
    • Serum blood titers cannot be more than 1 year-old from the start of matriculation.
    • You must submit the actual laboratory reports for the above serum blood titers. Please ensure that reference range are indicated on the quantitative results.
  3. Rabies titer (applies to Veterinary Medicine students only): must be a Rapid Fluorescent Focus Inhibition Test (known as a RFFIT) and ONLY if the Rabies vaccine series was received/completed prior to enrolling for fall semester classes. Please note the RFFIT is the only rabies titer we will accept. This titer is due no later than September 30th of the current year.
  4. Based upon your health history or current health status, if a particular immunization is medically (temporarily/permanently) contraindicated, a signed letter from your licensed healthcare provider attesting to this contraindication will be acceptable. However, you will still be responsible for obtaining the immunization clearance as soon as your temporary health issue is resolved. You will not be cleared to start any clinical rotations without this clearance.
  5. Hepatitis B vaccine series: if you have initiated the Hepatitis B vaccination series prior to starting classes, but have not yet completed the series, registration for your first semester of classes will not be delayed, if you submit documentation showing you have started the Hepatitis B vaccination However, you will need to submit proof of receiving the remaining vaccine(s) as soon as they are due, or a hold will be placed on your student account. You must also provide a Hepatitis B Surf AB QN titer, which was drawn at least 30-days after your last Hepatitis B vaccine.
  6. Tetanus/Diphtheria/Acellular Pertussis (Tdap) booster: we require one documented Tdap booster within the last 10 An immunization record is required for this vaccination.
  7. Tuberculosis (TB) clearance: YEARLY REQUIREMENT NOTE: If you need to have the 2-step (meaning 2 separate) PPD skin test, they must be at least 7 days apart or they will not be accepted. It is your responsibility to renew your yearly TB clearance and submit it to SEHO before it expires. The only acceptable TB clearance is one of the following:
    • Tuberculin Skin Test (commonly known as a PPD): PPD results must be read 48- to 72-hours after administration and the results must indicate millimeters of induration and not simply “negative” or “positive.” The form must be dated and signed by a licensed healthcare provider, or it will not be
    • IGRA lab test: reports cannot be more than 6 months from date of starting classes and must indicate qualitative results. This blood test is valid at WesternU for four (4) years however students must also submit a completed, signed and dated TB Symptoms Health Screening checklist form on a yearly basis to the Student Health This test is preferred if you have a history of having received a BCG vaccine.
    • Chest x-ray: If you have a prior history of latent TB infection (LTBI) as determined through a tuberculin skin test (PPD) or a blood test (IGRA), a licensed healthcare provider must provide a signed, written report that shows you do not have active TB disease. If a chest x-ray was required for TB clearance, a copy of the actual radiology report and a completed TB Symptoms Health Screening checklist form must accompany your health clearance documents. Please note that the chest x-ray cannot have been taken more than 6-months prior to the start of your start of your
    • Prior history of active pulmonary TB: a licensed physician must provide a signed, written report that must show you have completed, or are in the process of completing, all required therapy. The report must include the name of the medications, dosages, frequency of administration, and total doses received. If you have completed the therapy, the report must state this fact, including the date the treatment was completed. If your treatment is still in process, the report must state when it is expected to be completed. Additionally, a chest x-ray report is required for admission clearance. You must provide a copy of the actual radiology report and it cannot be more than 6-months old if: 1) you have completed the treatment and/or, 2) from the day you start class.
    • History of BCG vaccination: prior BCG vaccination is NOT a contraindication to either PPD or IGRA. IGRA test is preferred if you have received a BCG vaccine in the past. In this setting, interpretation of the results of screening tests for TB infection will take into account each of the following:
      • the length of time between past BCG vaccination and the screening test; and
      • the risk of infection with Mycobacterium tuberculosis.
  1. Influenza vaccination: YEARLY REQUIREMENT—all students must receive the annual influenza vaccination every fall. Documentation of receipt of this vaccination is required and must be submitted to your Castle Branch account no later than the November 30th each year or a hold will be placed on your If you have a medical contraindication to receiving the yearly influenza vaccine, a note from your healthcare provider on their letterhead, that is also signed/dated is required. An email “letter” or “note” will not be accepted.

Veterinary Students ONLY

  1. Rabies vaccination: Students enrolling in the DVM program must provide all of the above documentation as well as show proof of having received the pre-exposure series of rabies immunization or agree to complete the rabies vaccinations as part of the University matriculation process no later than September 30th of the current year.
    1. A pre-exposure series involves the administration of two (2) intramuscular doses of the vaccine given on days 0 and 7.
    2. You can begin receiving your rabies vaccination series now or during orientation week on campus at the WesternU Health A fee is charged for each of the vaccines you have to receive. For pricing, please call 909-706-3730.

Students who have previously received the Rabies vaccine series may be excused from being re-vaccinated by providing official documentation from their healthcare provider stating the dates they received 2 rabies vaccines. The serum RFFIT titer (which measures level of immunity to rabies) must be done if the two (2) vaccines were received/completed prior to enrolling for fall semester classes. The titer result is due no later than September 30th of the current year.


  • Why do I need to submit my immunization records and serum titers?

    Many clinical rotation sites require copies of both your immunization records and serum titer results. When you are preparing to start at a clinical rotation site that requires this information, you will just need to check your Castle Branch account to obtain the required documents. (If you are having trouble locating your immunization records, you may want to check with your high school/undergraduate college/university Health Center to see if they have a copy of your immunization records).

  • If my healthcare provider writes a note stating I have had a communicable disease, is this acceptable?

    No. Documentation of select communicable diseases that were “physician diagnosed” and not confirmed through blood tests, are not accepted as evidence of immunity. Because of this, the required vaccine preventable diseases that have blood tests to determine if immunity exists or not (referred to as titers), are required for hepatitis B, measles, mumps, rubella, and varicella.

  • If my healthcare provider writes a note stating the student “is up-to-date on all vaccines,” is this acceptable?

    No. Documentation requirements for your health records must show the specific dates you received each vaccine. Health records may be in the form of original vaccination records (or a clear copy) or a letter from the healthcare provider on their letterhead or printed prescription (no emails allowed) stating the vaccine name and dates each was administered. The letter must be signed by the healthcare provider. We will not accept school records, family member statements or baby book entries.

  • If I get behind in a vaccination series (i.e., hepatitis B, MMR, or varicella), what should I do?

    You will pick up where you left off and complete the vaccination series. For example, you received the first shot of the Hepatitis B vaccine series, but you have not received the rest of the vaccine, your healthcare provider can determine what else may be needed. If you can show you have started a vaccine series, you will be allowed to register for your first semester but until you provide proof you have completed the series, you will not be allowed to register for any subsequent semesters/classes or receive financial aid.

  • If I received a Hepatitis B vaccine dose earlier than the minimum interval recommended, is this acceptable?

    No it is not. The dose of vaccine is invalid and must be re-administered after the minimum interval has been met. For example, the Engerix B, Recombivax (3 doses needed to complete series) minimum intervals are as follows: Dose 1 is administered. Dose 2 should be separated from dose 1 by at least one month (4 weeks or 28 days). Dose 3 should be separated from dose 2 by at least 2 months (8 weeks) AND from dose 1 by at least 4 months (16 weeks). For Heplisav B vaccine (2 doses are needed to complete series) minimum intervals are as follows : Dose 1 is administered. Dose 2 should be separated from dose 1 by at least one month (4 weeks or 28 days).

  • Will vaccines interfere with my TB skin test (commonly known as a PPD) results?

    Some vaccines may. For example, the MMR vaccine may interfere with PPD results (may have a false negative result in someone who has an infection with TB) if the vaccine is administered within 4-weeks of the PPD. However, the MMR vaccine can be administered at the same time and on the same day as the PPD. The hepatitis B, tetanus and rabies vaccines can be administered any time without interfering with PPD results.

  • How do I know if my 1st PPD will be accepted or counted?

    Your 1st PPD will be accepted or counted if it was completed within the last year. If it is more than 365 days from when it was administered, it will not be accepted or counted.

  • If I received the TB skin test at WesternU, can I have a healthcare provider at a non-WesternU clinical rotation site read the TB skin test results and document them?

    If your clinical site is near a WesternU campus, then the answer is no. It must be read at WesternU, and documentation must then be provided to the SEHO. However, if your clinical rotation site is not near the campus, you can have the TB skin test read by the Employee/Occupational Health nurse at the clinical facility you are rotating through. The results can be uploaded to your Castle Branch account.

  • Can I submit an IGRA (e.g., Quantiferon or T-spot) blood test for TB clearance?

    Yes, but only if you do not have a history of a positive Tb skin test. The test cannot be more than 6 months from your first day of matriculation. This test is valid at WesternU for 4 years. However, you are still required to submit a completed TB Symptoms Health Screening Checklist form on a yearly basis via your Castle Branch account.

  • Do I only have to complete a TB clearance on a yearly basis?

    Yes. Be aware that some clinical rotations sites have more stringent TB clearance requirements that you must comply with in order for you to be permitted to go or remain at that site.

  • Do I need to get a PPD or IGRA (Quantiferon/T-Spot) if I have a history of a positive PPD?

    No. You are required to obtain a chest x-ray (x-ray cannot be more than 6 months old from your first day of starting classes at WesternU) and complete the online TB Symptoms Health Screening Checklist form or the one that is included in this packet. We do not need the actual chest x-ray film; we only need the radiologist’s written report.

  • I am healthy. Why should I be required to show that I have been immunized?

    As members of the WesternU community, it is especially important for all of us to be free from communicable diseases that can threaten those around us. Many of these diseases are preventable with appropriate vaccination. Also, in order for you to participate in your required clinical rotations, you must be able to show proof that you are not at risk for contracting or transmitting vaccine preventable communicable diseases.

  • If I received my second Hepatitis B vaccine (either the Engerix-B or Recombivax) later than recommended after the first vaccine, how soon after getting the second Hepatitis B vaccine can I receive the third and final Hepatitis B vaccine?

    If you had the 2nd vaccine several months after the first one, you could receive your 3rd and final Hepatitis B vaccine 60-days after the 2nd vaccine. A serum blood titer is still required 30-days after vaccine number three.

  • If I have completed 2 full Hepatitis B series and my titer is still showing I do not have immunity, do I need to complete another series?

    No, because most likely you are a non-converter, however, you will need to provide SEHO with the documentation showing that you have completed 2 entire Hepatitis B vaccination series and a current Hepatitis B Surface Ab, QN titer.

  • What should I do if the blood titers show I am not immune to the vaccine preventable disease(s)?

    Unless you have a documented medical condition that contraindicates the administration of the vaccine(s), you may be required to be vaccinated/revaccinated for those diseases that you have no or low immunity against.

  • When is a rabies titer needed?

    If you are a veterinary medicine student who has already completed the rabies vaccination series (2 vaccines) prior to enrolling to fall semester classes, you are required to have a rabies titer and submit the titer results along with the dates you received each of the rabies vaccine. In accordance with the Centers for Disease Control and Prevention (CDC), the recommended serum blood test for rabies is called rapid fluorescent focus inhibition test (RFFIT). No other rabies testing results will be accepted (CDC Rabies information).

  • What would happen to me if I don’t complete the health clearance requirements?

    Every incoming student, whether new to WesternU, repeating or returning from a leave of absence, is required to comply with all health clearance requirements. If you do not complete these requirements, a registration hold will be placed, or in extreme cases, your acceptance to attend WesternU may be rescinded.

  • I am going to be returning to WesternU after being on a leave of absence for more than 6 months. Do I have to do the entire health clearance process?

    If you have already submitted serum titers (as described/required in the health clearance packet) and immunizations records, then all you will need to submit is an updated medical history, physical exam, and TB clearance. Additionally, if your serum titers are more than 4 years old, you will need to have them repeated.

  • If I have had the Hepatitis B disease and my physician says I do not need to have the Hepatitis B vaccination series, what should I ask my physician to include in the health records and documents I will be submitting to SEHO via Castle Branch?

    Have your physician provide the lab test results that confirm a prior Hepatitis B diagnosis and include a note about the status of your Hepatitis B disease [for example, “continue to monitor viral loads every 6 months”] on the History and Physical examination form your physician completes. (This would also apply to those persons who have a “native immunity” to Hepatitis B.)

  • What if I have a health condition that is a contraindication to receiving a particular vaccination?

    A letter from your healthcare provider attesting to this contraindication will be acceptable. However, if your current health status is such that a particular immunization is temporarily contraindicated, you will still be responsible for obtaining that immunization as soon as your health issue has resolved and likely prior to starting any clinical rotation.

  • What if my religious beliefs do not allow me to be immunized?

    There are no religious exemption from the University immunization requirements. One should explore with his/her healthcare provider for the availability of vaccine formulations that do not involve the use of blood or select animal products, or document immunity as a result of prior infection. The University’s commitment to minimize the potential harm to you and any patients or colleagues that you may encounter in your future career is of paramount concern to the university. Only a legitimate medical contraindication to vaccination will exempt a student from the University’s immunization requirements.

  • Can I participate in clinical rotations if I am still updating/completing the required vaccines and TB clearance?

    In order for you to be able to start your clinical rotations you must be up to date on all your required vaccinations, TB clearance and serum blood titers. You must provide proof that you have completed all of the communicable disease clearance requirements or you will be removed from clinical rotations; will not be allowed to register for the next semester; and if you receive financial aid, you will not receive your funds until these requirements have been fulfilled.

  • If I am pregnant can I be vaccinated safely?

    Some vaccines can be administered safely during pregnancy. However, it is recommended that you consult with your obstetrician prior to receiving any vaccines.

  • If I am pregnant, can I participate in my clinical rotations without having completed the required vaccinations?

    A pregnant student can receive a temporary medical exemption and still participate in some clinical rotations. However, it is strongly recommended that you work closely with your college’s clinical rotation coordinator to determine if it is permitted by the clinical site you would be going to, as well as your obstetrician.

  • How long will it take to process my health clearance forms?

    You will need to allow at least 10 (ten) business days from the date you uploaded all of your required health clearance forms in your Castle Branch account. If you have not received a confirmation email from the Student Health Office by the end of the 10th business day, you should contact us. Note: all forms are processed on a first come, first served basis only.

  • When is the deadline for submission of all my health clearance forms/documents?

    The completed health clearance packet is due no later than 30 days before class registration open. Please check your registration dates.

  • Once I have submitted all health clearance documents in my Castle Branch account, will I have to do any other communicable disease tests, receive more immunizations or obtain a physical exam?

    You are required to obtain a yearly influenza vaccination and complete annual TB clearance and upload them into your Castle Branch account. Additional tests, vaccines and physical exams may be required for a clinical rotation site. It is your responsibility to confirm what is needed to clear you to rotate any site. Please provide copies of any additional health clearance document to the Student Health Office.

  • If I am feeling overwhelmed or my stress level is increasing, is there some place on campus where can I get help?

    We have a department referred to as LEAD. They specialize in six main topics that support students through their academic journey here at WesternU. These areas include a) one-on-one academic counseling, b) tutoring, c) the annual Summer Preparedness and Readiness Course (SPaRC), d) the Wellbeing Initiative, e) LEAD CALM – Mindfulness Meditation Training & Practice, and f) various workshops relevant to student life. All LEAD services are free of charge to the WesternU community, and all services are completely confidential.

    If you need access to emergency student resources, call one of the following 24/7 hotlines: