University of Hawai’i at Hilo
The Daniel K. Inouye College of Pharmacy
Health Screening Requirements
Checklist
Please initial each box that you are submitting documentation for.
If any of the boxes are not applicable to your situation please mark it off as N/A; example: Not everyone
will need to get a chest x-ray.
2-Step PPD- Documentation of placement dates, read dates, results, and size (in mm) of a 2-step
PPD/Mantoux (TB) after September 2016 (within one year of enrollment).
A 2-Step requires that you get two PPD skin tests; the second one should be administered AT LEAST 7
days after the 1st PPD is given.
Chest X-Ray-Documentation of Chest X-ray results if you have a documented positive PPD reading of
10 mm or higher. Chest X-ray must be dated after September 2016. Proof of past Positive PPD is also
required.
Positive Antibody Titer for Hepatitis B- Lab documentation of Hepatitis B Surface Ab Titer. If
immunity is not present, student must receive a 4th Hepatitis B (challenge dose) followed by another
serum blood titer 1 to 2 months later; if antibody titer is still negative, student will then receive the
remaining 2 doses of a second series and test blood serum again 1 to 2 months after 3rd and final
dose, as indicated per CDC recommendation.
Positive Antibody Titers for Measles/Rubeola, Mumps, and Rubella OR 2 MMR VaccinationsDocumentation of two (2) MMR vaccinations OR lab documentation of IgG Antibody Titer results for
Measles/Rubeola, Mumps, and Rubella.
Positive Antibody Titer for Varicella OR 2 Varicella Vaccinations- Documentation of two (2) Varicella
vaccinations OR lab documentation of IgG Antibody Titer results for Varicella.
Tdap Vaccination- Documentation of a Tdap vaccination dated after 1/1/2005.
Two (2) Additional Tetanus Vaccinations- Td, Tdap, DPT, DT, DTaP, OR DTP (Childhood records will
suffice). If no documented history of tetanus- Receive a Tdap, followed by a Td booster 4 weeks
later and another Td booster 6 months later.
One of your Tdap or Td vaccines needs to be within the past 10 years.
Health Insurance- Documentation of Health Insurance Coverage (DKICP has no preference or
recommendation of coverage, please be aware that the University is not responsible for any form of
payment if you become sick or injured at school or on a rotation).
(Due August 14, 2017 or sooner)
I am aware that the above requirements are mandatory and if I do not submit
all required documents before June 1, 2017 it may jeopardize my enrollment.