How to Complete and Submit the University of Hawaii Health Clearance Form

To register for in-person classes at the University of Hawaii, you need to complete the University of Hawaii health clearance form, have it signed by a U.S.-licensed healthcare provider, and upload it to the Med+Proctor portal using your UH student email. The form documents required immunizations and tuberculosis clearance under Hawaii Administrative Rules Chapter 11-157.¹ Until Med+Proctor verifies your records, your account is restricted to online-only courses.²

Download the Form and Pull Your Records

The blank PDF is posted on the University of Hawaii system website.³ Print it and bring it to your medical appointment along with everything you can gather in advance:

Vaccination records from previous schools, pediatricians, clinics, or your state immunization registry, with full month-day-year dates for every dose.
Your UH student ID number, which is required on both the form and the portal.
Any TB skin test, blood test, or chest x-ray results from the past twelve months.
If you had chickenpox rather than the vaccine, a signed statement from a doctor confirming the diagnosis.

The clinical sections must be completed and signed by a U.S.-licensed MD, DO, APRN, or PA. The provider does not have to be the one who originally gave you the shots; any licensed provider can review your records and sign off.⁴ A clinic stamp works in place of the signature.

Vaccines the Form Must Document

Measles, Mumps, and Rubella (MMR)

Two doses are required. The first must have been given on or after twelve months of age, and the second at least four weeks after the first. Positive antibody titers for measles and rubella can substitute for proof of vaccination, but Hawaii does not accept titers for mumps. Even a complete MMR titer panel still fails the mumps component without documented vaccine dates.² Students born before 1957 are exempt from MMR.¹

Varicella

Two doses are required, with the first given after twelve months of age.² A documented history of chickenpox or shingles, confirmed in writing by an MD, DO, NP, or PA, can substitute.⁴ Blood titer results are not accepted for varicella. Students born in the United States before 1980 are exempt.⁵

Tdap

One dose of Tdap is required, administered on or after age ten.⁶ A childhood DTaP given before age ten does not satisfy the requirement. You need the adolescent or adult booster.

Meningococcal Conjugate (Housing Only)

If you are 21 or younger and moving into university housing for the first time, you also need one dose of MCV4 (covering serogroups A, C, Y, and W-135), given on or after age sixteen.² Commuters and students over 21 do not need it. Without it, residential students cannot check in to housing.⁷

TB Clearance

TB clearance is a separate requirement, and many students clear it without any test. The provider fills out the State of Hawaii TB Risk Assessment Form, checking for symptoms (a cough lasting three or more weeks, fever, night sweats, unexplained weight loss) and risk factors (birth in a country with elevated TB rates, extended travel to high-risk areas, contact with someone who had infectious TB, or an immunocompromising condition).⁸ If every answer is negative and you have no symptoms, the provider signs off and no test is needed.

If anything on the assessment comes back positive, you need either a Mantoux skin test (PPD) or a QuantiFERON Gold or T-SPOT blood test. Skin test results must be read 48 to 72 hours after injection and documented as the induration measurement in millimeters. A result recorded only as “negative” or “positive” without the millimeter number will be rejected.² A positive skin or blood test requires a chest x-ray before clearance can be issued.¹

The whole TB clearance must have been completed within twelve months before your first semester, or on or after age sixteen.² One timing trap: if you just received the MMR or varicella vaccine (both live), wait at least four weeks before a TB skin or blood test. If you cannot wait, a chest x-ray can serve as a preliminary substitute so you still make the deadline.⁹

Uploading to Med+Proctor

The University of Hawaii uses Med+Proctor as its single intake portal. You cannot hand-deliver or email records to the registrar.² Go to medproctor.com and create an account using your UH student email address. Personal email addresses are not accepted. Some campuses route you through a single sign-on tied to your campus portal credentials instead.

Submission is free. Med+Proctor will offer an optional paid upgrade that lets you keep access to your uploaded documents after graduation; you can skip it by clicking “no thank you” at the bottom of the upgrade screen.¹⁰ Upload a clear scan or photograph of your completed, signed form, with all four corners visible and the text legible. The portal accepts image files and PDFs only. Word documents are rejected.² You will get an email confirmation once verification is complete and the registration hold is lifted.

Common Reasons Forms Get Rejected

Most delays trace back to the same handful of problems. Catching them before you leave the clinic saves a second appointment:

TB skin test results written as “negative” or “positive” without the induration in millimeters.²
Vaccination dates missing the day. Month-day-year is the standard; incomplete dates may be rejected.¹
A mumps titer in place of MMR vaccine records. Hawaii does not accept serologic evidence of mumps immunity.²
A varicella titer in place of vaccine records or a provider-signed disease history.²
Military immunization records that list MMR as a titer rather than as vaccination dates.²
Documents uploaded as Word files instead of PDFs or images.
Clinical sections without a provider signature or clinic stamp.²

Medical and Religious Exemptions

Hawaii allows two exemptions from the immunization requirements. Neither releases you from TB clearance, which is always required for courses lasting longer than six months.¹

For a medical exemption, a licensed provider (MD, DO, APRN with prescriptive authority, or PA) completes the Medical Exemption Form (Epi-8), naming the specific vaccines that are contraindicated and the duration of the exemption.¹¹ A blanket letter without specific vaccines and a timeframe will not be accepted.

For a religious exemption, file the Request for Exemption from Vaccination on Religious Grounds (Epi 7B). You initial three required statements: that vaccination conflicts with your bona fide religious practices, that the exemption will not be recognized during an outbreak, and that you cannot pick and choose which vaccines to exempt. The exemption covers all required immunizations or none.¹² Personal or philosophical objections are not an accepted basis.

Both exemption types carry the same catch. If the Hawaii Department of Health declares an outbreak of a disease your exemption covers, the exemption is suspended and you are excluded from campus until the threat passes.¹¹

Fully Online Students

Students enrolled exclusively in online or remote courses are not required to submit health clearance.¹³ Register for even one in-person or hybrid class and the full requirement kicks in, so plan to complete the form before you add that section.

If You Miss the Deadline

Without verified clearance on file by the first day of the semester, you can register for online courses only. In-person and hybrid classes remain locked until Med+Proctor confirms your documentation.² Housing check-in can also be blocked. The hold lifts as soon as your clearance is verified, so a late submission is recoverable, but popular sections may fill while you wait, and financial aid tied to full-time enrollment can be affected if you cannot register for enough credits.

1
Hawaii Department of Health. Hawaii Administrative Rules Title 11 Chapter 157 Examination and Immunization
2
University of Hawaii. Health Clearance
3
University of Hawaii. Health Immunization Clearance Form
4
University of Hawaii. Health Clearance Requirements for Registration
5
Hawaii Department of Health. Immunization Requirements for Post-Secondary School Entry
6
Hawaii Department of Health. Immunization Requirements Summary
7
University of Hawaii. Health Clearance Requirements – University Health Services Manoa
8
Hawaii State Department of Health. TB Risk Assessment for Adults and Children
9
University of Hawai’i Mānoa. Frequently Asked Questions Regarding Health Clearance
10
Med+Proctor. How to Submit My Documents to Med+Proctor
11
State of Hawaii Department of Health. Medical Exemption Form
12
State of Hawaii Department of Health. Request for Exemption from Vaccination on Religious Grounds
13
Cornell Law Institute. Hawaii Code R 11-157-5 – Exemptions