INSTRUCTIONS FOR APPOINTMENT
HEALTH SCIENCES IMMUNIZATION PROGRAM (HSIP)
Office of the Practicum
TO : All MSW Foundation Day Students
Autumn Quarter 2009
FROM: Cheryl Yates (112 D, 543-8618,firstname.lastname@example.org)
DATE: August 2009
RE : Meeting the University of Washington’s Immunization Requirements
All incoming health sciences students must show documentation of protection against several vaccine-
preventable diseases. The requirements and the process for achieving compliance are summarized at the
website http://hallhealth.washington.edu/hsi . A downloadable brochure at this site entitled “2009-2010
Required Immunizations for Health Sciences Students at the University of Washington” also contains this
information. Students who do not achieve compliance with all the requirements may not be allowed to start
Practicum, or registration may be blocked. This could adversely affect completion of necessary coursework
or jeopardize future financial aid.
Please note that a one-time $275 health fee covers costs of all required immunization updates during the
course of the curriculum. It does not need to be paid in advance of the initial immunization appointment.
Detailed information about the health fee is available on the above mentioned website, as is another
downloadable brochure on this topic.
Hall Health Primary Care Center (HHPCC), the University’s student health service, works with the HSIP to
provide immunization and counseling services that assist students in achieving and maintaining compliance.
This means that students who have paid the health fee incur no additional charges for health fee authorized
services provided by HHPCC to assist them with meeting the HSIP requirements.
Students must be registered as patients at HHPCC prior to receiving these services.
What you need to do:
1. Download, complete, and sign the top portion of the 2-sided form entitled “2009-2010
REQUIRED IMMUNIZATIONS FOR HEALTH SCIENCE PROGRAMS”.
2. Obtain copies of your immunization records or other supporting documentation per the
brochure/information on the website. Some of the places you may want to check for records
includes: physicians’ offices, other schools’ student health service clinics, or an employee health
clinic if you have been working or volunteering in a health care facility. NOTE: always keep a
copy of your documentation for your personal records.
3. If you prefer, you may have your health care provider complete the 2-sided form. Each section
must be verified and initialed by the provider, along with the identifying information at the
bottom of the reverse side. If you choose this option, it is still recommended that you bring
supporting documentation to your appointment, so that any questions about the information your
provider supplied can be clarified if needed.
4. Download, complete, and send to HHPCC the pre-registration form from the HSIP section of
the HHPCC website. The insurance section may be left blank if you do not have this
information. NOTE: This MUST BE DONE prior to your appointment date, and preferably AS
SOON AS POSSIBLE; your appointment may have to be rescheduled if you fail to pre-register.
5. Attend the immunization appointment at the time and date noted below; bring the 2-sided
“Required Immunizations” form, and any documentation you obtained. If you already received
the required immunizations elsewhere, please DO NOT MAIL OR FAX
DOCUMENTATION TO THE IMMUNIZATION CLINIC OR TO THE SCHOOL OF
SOCIAL WORK PRACTICUM OFFICE. All documentation of immunizations and tests
must be provided in person during the immunization appointment.
6. Attend all follow-up immunization appointments as instructed by the clinic staff (number of
follow-ups varies from individual to individual).
The School of Social Work has already scheduled immunization review appointments for your class for
three different dates. The first group will be seen on Monday, September 21. The second group will be
seen on Tuesday, September 22, and the third group will be seen on Friday, September 25, The location
of ALL clinics is in the HEALTH SCIENCES BUILDING,T-Wing, room T-365. NOT Hall Health.
Appointments are 40 minutes long and include enough time to receive immunizations should this be deemed
necessary. You are scheduled for different time slots as follows:
_____________________MONDAY, SEPTEMBER 21 ________________________________________
8:10 am Adams, Andag, Arachchi, Barrans 2:50 Irwin, Jackson, Johnson, Keenan
8:50 Bott, Bowes, Bowling, Burgess 3:30 Khakimova, Kulas, LaPoint,
9:30 Carney, Carter, Casagrande, Cutter Larsen-Cooper
10:10 Daliva, Day, Durr, Egoavil Students who receive a TB skin test MUST
10:50 Farwell, Feig, Fredenberg, Frey RETURN ON WED., SEPT. 23 for the TB
11:30 Friedman Simmons, Givan, Gizaw Godina reading to T365
1:30 Gritsch, Guillen, Hackett, Hains
2:10 Hale, Healy, Henderson, Hwang
_____________________TUESDAY, SEPTEMBER 22____________________________________
9:30 Lewis, Lord, Madsen N., Madsen T.
10:10 Martin A., Martin M., Mass, McOwen
10:50 Moore, Morris, Morse, Nierman Students who receive a TB skin test MUST
11:30 Obrist, Ogburn, Ortega, Parrish RETURN ON FRI., SEPT. 25 for the TB
1:30 Penney, Pope, Pugh, Quinn reading to T365
2:10 Rabun, Raghunand, Ramey, Randle
2:50 Redenbaugh, Redmond, Rees, Rosas-Ferrer
3:30 Rosenbaum, Ryan, Si, Siciliano
_____________________FRIDAY, SEPTEMBER 25________________________________________
8:10 Silva, Smaus, Smith, Solursh 2:50 Walker, Walsh, Warren,Whiting
8:50 Soto, Stein, Stewart, Storms 3:30 Wilson, Woolley, Wulff-Sfady, Xczar
9:30 Teichow, Terry, Thompson-Pratt, Torres-Clara
2:10 Tran, Unger, Vincler, Wadlington Students who receive a TB skin test
MUST RETURN ON MON., SEPT. 28
for the TB reading to T365
Contact information for the HSIP is provided in the brochures for those who have specific questions about
the immunization requirements.
Special Instructions: If you were in a practicum site last year where you were required to meet
immunization requirements for the UW/School of Social Work, please contact the HSIP about your specific
update requirements for this academic year. TB tests are required annually and may be taken care of on a
drop-in basis. Once you start your placement, if you do not continue the requirements on schedule you and
your Practicum Instructor will be notified that you may not continue in your placement and you will NOT
receive credit for your practicum course. Please let us know if you have any questions or concerns or if you
are having particular difficulty contacting the HSIP staff.
c:yatesc\2009 MSW Foundation Day Immunization Cover Memo