NMWC Forms & Fees

Students can utilize the NMWC services to complete medical forms and requirements for our Nursing & Allied Health programs. The Clinic provides a convenient low cost option for students to receive: Physical Exams, Titers*, Tuberculosis Screenings (PPD testing) and Immunizations. Our office manager can provide individualized assistance for completing forms as well as scheduling clinic services. Appointments are required.

Allied Health Programs

Allied Health Checklists
COVID-19 Daily Temperature and Symptom Monitoring Form
Allied Health Program Professional Technical Standards
Student Admission Physical Form
One-Step Tuberculin Skin Test Form
Two-Step Tuberculin Skin Test Form
COVID-19 Consent Waiver - High Exposure Activities
Healthcare Personnel Vaccination Recommendations
Respiratory Medical Questionnaire/Examination
Health Professional Medical Clearance for Respirator Fit Testing
N95 Fit Testing Completion


Physical Exams:
School Physical $25.00
Sports Participation Physical $35.00
Well Exam $25.00
Health Risk Assessment FREE
Tuberculin Skin Test 2-step (PPD):  
(2-step TST requires 4 appointments within a 3-week time period)  
Step 1 Administer $20.00
(Present to clinic for administration, return to clinic 48-72 hours for result)  
Step 2 Administer one week after step 1 result $20.00
(Present to clinic for administration, return to clinic 48-72 hours for result)  
TDAP (tetanus, diphtheria, pertussis) $60.00
MMR   $90.00
Hepatitis B $60.00
Influenza $20.00
Hepatitis B  $40.00
MMR  $120.00
Varicella  $40.00
Wellness Screenings:
Cholesterol  (requires fasting 15 hours, NO caffeine) $30.00
Diabetes screen Hemoglobin A1c $20.00


Appointments are required: Please call Anna Kephart, NMWC Office Manager @ 301-784-5670


Cash, check, or credit card payment will be collected at the time of service.

Services may also be paid using financial aid (via the bookstore) for eligible students. 


*prices effective Sept. 1, 2019

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