Health and Safety Forms

These forms are for ALL Allied Health Programs.

Safety & Certification

Safety is now done through HealthStream. Print your Rapid Regulatory Clinical I & Rapid Regulatory Clinical II Certificates of Completion and upload them to your Immunization and Document Tracker profile in American DataBank.

Physical Forms

• Medical Document Manager Requirements (PDF)
• Student COVID-19 Attestation (PDF)
• Skills, Simulation & Computer Lab Agreement (PDF)
• Skills, Simulation & Computer Expectations (PDF)
• Handbook Policy Agreement (PDF)
• Measles, Mumps & Rubella (MMR) Immunization (PDF)
• Confidentiality Agreement (PDF)
• Varicella (Chicken Pox) Immunization (PDF)
• Physical Exam Form (PDF)
• Seasonal Influenza Immunization (PDF)
• Tetanus, Diphtheria, Pertussis (Tdap) Immunization (PDF)
• Hepatitis B Vaccination Series and Titer (PDF)
• Hepatitis B Vaccination Declination (PDF)
• Tuberculosis (TB) Examination (PDF)
• Tuberculosis (TB) Questionnaire (PDF)
• Medical Release Form (PDF)

**If you have a TB Chest X-Ray you will need to fill out a TB Questionnaire each year.

UPDATE TO PROGRAM REQUIREMENTS: To meet the needs of our community clinical sites and for the health and safety of our students while in our Nursing/Allied Health programs, we are now requiring that students meet COVID Vaccination and Booster requirements upon entry into the program. NO exemptions will be considered.

Where to get Immunizations

Looking for somewhere to get your immunizations? Be sure to follow the Physical Exam/Immunization Guidelines above carefully!

• Your primary physician
• Bakersfield College Student Health Center
  Physical, Influenza, TB Exams  (FREE for BC Students)
  » More Information
• Irene Sanchez, M.D. Occupational Medicine
  Physical, Mask Fit, MMR, TB, Influenza, Hep B
• Bakersfield Health Department
  (661) 868-0306 or 1 (800) 974-2717
  Hours: Monday-Friday, 8 am - 5 pm
  1800 Mt. Vernon Ave.
  Bakersfield, CA 93306