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Certain immunizations are required for attendance

Per State and University policies, proof of certain immunizations are required for attendance. To fulfill this requirement, please complete the Immunization Form.

To return these forms to the USI Deaconess Clinic, you may:

  • Fax them to 812-465-7170
  • Email them to
  • Deliver them in person to the USI Deaconess Clinic, located on the top floor of the Fitness Center room 363
  • Mail them to:
    University of Southern Indiana
  • Attn: Immunizations
  • USI Deaconess Clinic
  • 8600 University Blvd
  • Fitness Center room 363
    Evansville, IN 47712

You must comply with the immunization regulations in order to be eligible to enroll at the University of Southern Indiana.

If you have any questions or concerns, please contact us at 812-461-5285.

Immunization Policy

All students entering the University of Southern Indiana for the first time or living in University Housing must meet the immunization requirements of the University and Indiana Code 21-40-5 enacted by the 2007 Indiana General Assembly.

To comply with the requirements, you must provide current documentation of the following immunizations:

  • MMR (Measles, Mumps, and Rubella):  The student must be immunized with two doses.  First MMR must be given after 1957 and not before first birthday.  Second dose must be given at least 30 days after the first. A physician’s written statement of immunity to measles and mumps due to having had the infection or proof of immunity through titers is acceptable.  Students born before January 1, 1957 are exempt from the MMR requirement.
  • Tetanus/diphtheria (TD booster/Tdap): Vaccination must have taken place within the past 10 years.  A tetanus toxoid alone NOT ACCEPTABLE.
  • Tuberculosis (International Students Only):  All International students (those who are not Citizens or Permanent Residents of the United States) must provide documentation of TB testing prior to the start of their first semester of enrollment at USI.  This testing must occur no earlier than 6 weeks before the start of the semester.  This test may be done with a TB blood test or a TB skin test administered in the United States by a medical professional.  Send medical documentation including your student ID number to the University Health Center (Contact information found below).
  • Meningitis vaccine: Meningococcal conjugate vaccine (MCV4) two immunizations if given before 16th birthday or one immunization if given on or after 16th birthday.

Acceptable documentation consists of one or more of the following:

  • Copy of your immunization records from high school or another postsecondary institution
  • Physicians’ statement showing the month, day and year during which the vaccinations were administered or infection was experienced. 
  • Completion of the USI Student Immunization form with doctor’s signature
  • Personal record maintained by your or your family showing the month, day and year during which the vaccinations were administered.


You may be granted an exemption from meeting state immunization requirements under certain conditions, such as a medical condition that contraindicates immunization, pregnancy or suspected pregnancy, religious objection, or participation in a current sequence of immunizations. You must provide the University with a written statement signed by your physician before an exemption for medical reasons will be considered.  Further information may be obtained by contacting the USI Deaconess Clinic at 812-465-1250 or located on the to floor of the Fitness Center room 363. Follow this link to access the Request to be Exempt from Immunization Requirements Form

Appropriate documentation concerning your request for exemption must be mailed, delivered or faxed to the University Health Center prior to the start of your first semester at USI. 

  • Fax 812-465-7170;
  • Email to
  • Brought to the USI Deaconess Clinic on the top floor of the Fitness Center RM363; or
  • Mailed to University of Southern Indiana, Immunizations FC363, 8600 University Blvd, Evansville, IN 47712.