Physician Immunization and Medical Report (PIMR) Information

The State of Rhode Island and Brown University require participants attending any of the University’s programs to be immunized against certain communicable diseases and provide documentation that they have visited a doctor in the past year. These immunization requirements are strict and may differ significantly from other states and countries; we cannot make exceptions to vaccine requirements based on a student’s home location. A vaccination not being offered or part of a routine vaccination schedule in your home state or country is not a reason for exemption from the requirement.

To comply, we must receive record of a physical exam you have undergone in 12 months prior to the beginning of your in-person program (e.g. a physical/yearly appointment or camp/sports physical)

To upload: Use the links provided in your checklist to upload your immunization record and your physical exam report. These links may be shared with your health care provider to upload directly.
To fax: (401) 863-3916

Brown Pre-College will accept immunization records from your healthcare provider that are dated within the last 12 months. If you do not have those records, please click below to download an immunization record form your health care provider can complete and you can then submit it in your Student Portal.

Vaccination Information:

Hepatitis B - One dose is required.
MMR - This vaccination protects against measles, mumps and rubella. Two doses of the MMR vaccination are required. (Two doses of separate vaccines against measles and mumps and one against rubella will be accepted.) A student must have received the second dose of the MMR or equivalent vaccination(s) at least two weeks prior to joining us in person. If a student does not have proof of vaccination, they may submit a form signed by a doctor that they have had a positive titer test for the antibodies for all three diseases. Proof of a titer must include the name of the lab test and the result.
Varicella - Varicella is also known as chicken pox. A student must have received two varicella vaccines. In some countries, the routine vaccination schedule may not include a vaccination against varicella, or may only include one vaccination. In lieu of providing proof of two vaccinations, a student may include, on a form signed by a doctor, their date of varicella infection or proof of titers positive for varicella antibodies. Proof of a titer must include the name of the lab test and the result.
Meningococcal Conjugate (MCV4) - One dose is required. This vaccination protects against four strains of meningitis: A, C, Y, and W-135. A vaccination against only one of these strains or a Meningitis B vaccination does not meet our requirements. Common brand names for this vaccination include, but are not limited to, Menactra, Nimenrix and Menveo. Please note that this vaccination is not available in some countries, but it is required in order to come to an in person program offered by Brown. Please be in touch with us at precollege@brown.edu if you will need to receive this vaccination in the U.S. when you travel here for our program and we will make a note in your record that your immunization forms may be late.
Tdap - One dose is required. This vaccination protects against tetanus, diphtheria and pertussis. Brand names that are acceptable are often, but not limited to, Adacel and Boostrix. This vaccination is distinct from the DTaP, which is given to younger children, and the DTaP is not an acceptable alternative. Your immunization record must specify that you have received the Tdap (in some countries called the dTap, but in all cases inclusive of a capital T and lower case d, a and p) in order to meet our requirements. Please note that some countries may provide a Td or a Td-IPV vaccination rather than a Tdap, and this does not meet our immunization requirements. This vaccination is not available in some countries, but it is required in order to come to an in person program offered by Brown. Please be in touch with us at precollege@brown.edu if you will need to receive this vaccination in the U.S. when you travel here for our program and we will make a note in your record that your immunization forms may be late.

Download Immunization Record

Frequently Asked Questions

Q: My parent/guardian knows the dates I received my shots. Can they sign the Immunization Record?

A: No. All immunization documentation and information must be certified by a healthcare provider or medical records official. We cannot accept self-reported immunization information.

Q: What if my last physical exam is more than 12 months prior to the start of my program?

A: If your last physical exam is more than 12 months prior to the start of your program, you will need to have an exam prior to the forms deadline so you can submit an updated examination record.

Q: What if I don't have enough time to complete the full series of certain vaccinations prior to the start of my program?

A: All Pre-College students participating in in-person programming must have completed their measles vaccinations at least two weeks prior to starting their program. For other immunizations requiring more than one inoculation (such as hepatitis B and varicella), you must submit proof that you have begun the series and had as many of the inoculations (shots) as possible within the time frame/schedule specified on the Physician Immunization and Medical Report. If these requirements are met, you are considered to be in compliance with the requirements for the program.

Q: What if my healthcare provider does not know the exact date I received the shot or does not have record of it?

Without the full dates of your vaccinations (including month, day, and year), your immunization history does not comply with Brown University requirements, and your documentation cannot be accepted. There may be a possibility of having an antibody titer blood test done to prove you had the vaccine in the past. Please speak to your healthcare provider about this option.

Q: Are there any exemptions from having immunizations?

A: You may apply exemptions from most immunizations by submitting a Rhode Island Department of Health Medical Immunization Exemption Certificate or a Rhode Island Department of Health Religious Immunization Exemption Certificate. Please send any medical exemption requests, regardless of which vaccine it pertains to, to vaccineexemptions@health.brown.edu. The deadline for medical exemption requests is May 31.

Please send any religious exemption requests, regardless of which vaccine it pertains to, to precollegevaccination@brown.edu. The deadline for religious exemption requests is May 31.

Q: Does Health Services or Brown University staff administer medication to participants?

A: No. Participants are responsible for managing and administering their own medication while attending programs. Parents/Guardians should discuss this structure with the participant to ensure the participant is prepared to manage this task on their own. If you have any questions, please call Health Services at 401-863-1330 and ask to speak to Nursing or email nursing@health.brown.edu prior to arriving on campus.

Q: Are the residence halls air-conditioned?

A: You will have a cooling unit in your residence hall room.

Q: Are refrigerators provided for participants in their residence halls?

A: You will have access to a refrigerator in your residence hall room or suite. All residence halls also have communal refrigerators.