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Student Health Center Information and Health Forms

 
The California State University Maritime Academy has health requirements for all degree programs because every student participates in an international experience which may include at least one training cruise. In addition, degree programs for which maritime licensing is a graduation requirement have additional physical and mental health requirements as determined by the U.S. Coast Guard.
 
In this section you will find the required health forms to be completed by you and your licensed healthcare provider (must be a U.S. licensed medical professional MD, DO, PA, or NP) and returned to the Student Health Center by May 1, 2017:
 
  • Health Report (7 pages total)
  • Student to complete pages 1, 2, 5, 6, & 7
  • Provider to complete pages 3 & 4; review and sign pages 2, 3 & 4
  • Information About Meningococcal Disease and Immunization
  • Notice of Privacy Practices
  • Abridgement of Drug Testing Policiy
Your Health Report may affect your eligibility for enrollment in certain majors. Therefore, it should be fully completed and returned as soon as possible, but no later than May 1, 2017 or within two weeks after the date you receive your acceptance letter, whichever is later. Those who wish a priority medical review prior to May 1st may receive one if the forms are submitted by April 1st, 2017. Receipt of the Health Report by April 1st, 2017 will ensure a full refund of your deposit in the event you are found ineligible for enrollment in certain majors due to health reasons. Additional medical documentation may be requested based on information contained in your Health Report. If requested please send this information to the Student Health Center as soon as possible. Delays in submitting requested information or incomplete forms will hold up your registration for classes.
 
Please mail all health information to the address below:
 
Cal Maritime
Student Health Center
200 Maritime Academy Drive
Vallejo, CA 94590
 
Any questions with regards to the Health Report may be directed to the Student Health Center at (707) 654-1170 or you may visit our web site at http://www.csum.edu/web/health-services/.
Mandatory Health Insurance Requirement-This form is NOT an Insurance Waiver
 
Due to the special nature of the educational experience at the Academy, which includes a training cruise and/or international travel, students are required to be covered by health insurance which includes worldwide coverage and travel assistance services. You will automatically be enrolled in, and charged for Cal Maritime's Health Insurance and Travel Assistance programs. If you have personal insurance that meets Cal Maritime's minimum requirements, you may be eligible for an annual insurance waiver. You must apply online for a waiver by the August, 2017 deadline. Please visit the Student Health Center website at http://www.csum.edu/web/health-services/required-health-insurance  for the deadline date, more information about these specific requirements and to find the link to apply for the annual waiver.
 
It is the student's responsibility to inform Cal Maritime when his/her health coverage changes.

 

Link to required health forms.

 


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"I'm Ready to Choose Cal Maritime. What do I Need to Do?"

"What is the deadline to tell you I'm coming and guarantee my space?"

May 1, 2017 (postmark for mailed items)

Contact the Admission Office

Mon-Fri 8:00am-5:00pm
admission@csum.edu

Phone:    (707) 654-1330
24/7 Fax: (707) 654-1336

Cal Maritime
Admission Office
200 Maritime Academy Dr.
Vallejo, CA 94590

Admission Process Deadlines


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