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Non-Employee Health Portal

  • Use this page for submission of non-employee vaccinations, TB screening and health history documents.
  • For questions regarding the two-step TB skin process, titers or other health requirements, please visit the FAQs (PDF).
  • The health requirements are to be met at your own expense.
  • Provide documentation for these vaccines and TB screening at least two weeks before the start date.

Please complete the form below.

* - Required Fields

First Name:*

Last Name*

Middle Name (if applicable):

Other name used (AKA, prior or maiden name):

Birthdate*

ID Number (if applicable):

Vaccination Requirements for All Contractors

COVID 19 Vaccination Requirements
Two (2) weeks should have passed since the completion of a COVID 19 vaccine series to be considered fully vaccinated.

The time frames below are the recommended timelines for completing vaccination. If the actual spacing of doses varies from the recommended schedule, it may still be acceptable. Please submit information on all received doses, and we will evaluate for completion.

COVID 19 vaccine series includes following:
*2 doses of Pfizer vaccine 21 days apart or
*2 doses of Moderna vaccine 1 month apart or
*1 dose of Janssen/Johnson & Johnson vaccine

Influenza Vaccine
(1 dose annually if working October 1-March 31)

 

Varicella (VAR) Vaccine
(2 doses or positive antibody titer)

Measles, Mumps, and Rubella (MMR) Vaccine
(2 doses or positive antibody titer)

Tetanus, Diphtheria and Acellular Pertussis (TDap) Vaccine
(1 one-time dose of Tdap vaccine. If Tdap more than 10 years ago, also need tetanus/diphtheria booster within 10 years.)

Hepatitis B Vaccination Requirements

(Only required for individuals who perform tasks that may involve exposure to blood or body fluids.)
Hepatitis B (HepB) Vaccine
(2-dose Heplisav-B or 3-dose Engerx-B or Recombivax HB and positive titer OR hepatitis B declination form if not vaccinated and not desiring hepatitis B immunization)

 

Meningococcal Vaccine

(Only required for microbiologists who are routinely exposed to isolates of Neisseria meningitidis. Both MenACWY and Meningitis B vaccines are required for these individuals.)
MenACWY vaccine:

Meningitis B vaccine:

 

Tuberculosis (TB) screening

Typical TB Requirements for New Applicants: (See below for exceptional circumstances.)
A baseline two-step TB skin test OR a TB blood test. (Must be performed 0-90 days prior to the UMMC start date. If documentation of a TB skin test completed within the past 12 months is provided, then only one TB skin test is required 0-90 days prior to UMMC start date.)
Tuberculosis (TB) Verification:

TB Requirements for Renewal Applicants
Complete and submit TB risk assessment form. Student and Employee Health staff will review and notify whether additional TB documentation is needed.
TB Risk Assessment:

Exceptional circumstances

  • New Applicants who are Prior BCG (TB) vaccine recipients:

    TB blood test within 90 days of UMMC start date. If blood test is positive, submit a chest x-ray report within 30 days of UMMC start date.
  • New applicants who are international arrivals to the U.S. within the past 5 years:

    TB (IGRA) blood test and a chest X-ray within 90 days of UMMC start date if from the countries with a high TB burden.

    Please click here for the list of countries.

    If you are not from any of the countries listed above, complete a TB blood test. If the test is positive, a chest X-ray is required.
  • New applicants with a prior positive TB screening test or TB disease:

    Prior Latent TB infection: Submit a copy of the positive TB test report, a copy of the most recent chest X-ray report and a treatment card, if medication was received.

    Prior TB disease: Submit the proof of treatment, a completed pulmonary history form and a clearance certificate or letter by the treating agency or a healthcare professional.
 

 

Educational Observers who will observe for 3 days or less should complete and submit a TB Screening Form. Student and Employee Health Staff will review this form to determine if TB test is required.