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
Allied Health Program Professional Technical Standards
Student Admission Physical Form
One-Step Tuberculin Skin Test Form
Two-Step Tuberculin Skin Test Form
Healthcare Personnel Vaccination Recommendations
N95
ACM Respiratory Medical Questionnaire
ACM Medical Clearance for Respirator Fit Testing
UPMC Medical Clearance for Respirator Fit Testing
UPMC Student N95 Process
N95 Fit Testing Completion Medical Clearance
Vaccination Waivers
Complete and submit to ahvaccinewaiver@allegany.edu for approval of your waiver request
UPMC Waiver Process
COVID-19 Vaccination Information and Record
COVID-19 Vaccination - Religious Exception Petition
COVID-19 Vaccination - Medical Exemption Petition
COVID-19 Clinical Sites (to be attached to Vaccine Waiver requests)
Influenza Vaccination Exemption Request Form
ACM Waiver Process
| 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) | ||
| Immunizations: | ||
| TDAP (tetanus, diphtheria, pertussis) | $60.00 | |
| Hepatitis B | $60.00 | |
| Influenza | $25.00 | |
| Titers: | ||
| 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.
