All registered students, regardless of number of credits taken, born during or after 1957 must provide proof of immunity against measles, mumps, and rubella or vaccination of 2 Measles, 1 Mumps, 1 Rubella.


Provide proof of vaccine given in last five years OR decline the vaccine through the patient portal.


Consent for Minors

All students under 18 at the start of classes will need a parental or guardian consent for treatment on file in the event you need health care.

Student Athlete Forms

REQUIRED ATHLETE HEALTH FORMS MUST BE COMPLETED ONLINE* in My Hazen, the patient portal, by August 1.

*Paper forms are no longer available.


Complete Annual Update For Returning Athletes Form

  • Incomplete forms cannot be saved and submitted
  • Once form is completed, click Submit
  • Returning athletes do not need to provide Sickle Cell status or a physical


1. New NCAA Athlete Health History

  • Answer all the questions in detail. Allow at least 20 minutes. Incomplete forms cannot be saved and submitted.
  • Once form is completed, click Submit.

2. Downloadable Forms: Physical Form

  • You must have a physical performed within the 12 months prior to the start of classes
  • Take this form to your doctor to be completed
    • It is recommended to obtain your NCAA physical with your primary doctor who knows you best. If that is not possible, Hazen can provide the physical. Please note there is a $50.00 charge for an NCAA physical if it is done at Hazen.
  • Scan and upload this form back to the MyHazen site for our review

3. Required Immunizations

  • Go to Immunization area and follow the instructions for Mandatory Immunizations

Once forms are processed, a secure message will be sent via My Hazen indicating missing requirements or clearance.

For more information from the Athletics Department about this process, visit our NCAA Compliance webpage

Health Care Proxy

The Health Care Proxy allows you to name someone to make decisions about your medical care—including decisions about life support—if you can no longer speak for yourself. This form is encouraged but not required.

Living Will

Living Will is a legal document that protects your right to refuse medical treatment you do not want or to request medical treatment you do want, in the event you lose the ability to make decisions for yourself. This form is encouraged but not required.