--- title: "Medical Assessment" type: "wiki" space: "School of ECE Field Placement" author: "Nadezda Tsygankova" created: 2023-10-20T12:42:25Z updated: 2026-05-25T15:29:20Z url: "https://students.senecapolytechnic.ca/spaces/276/school-of-ece-field-placement/wiki/view/11552/medical-assessment" --- # Medical Assessment Please download, print and bring this [Seneca School of ECE Medical Assessment Form](https://students.senecapolytechnic.ca/attachment?file=Wg7qNUyreXTtz%2B750%2Bp3Xg%3D%3D) to your doctor for them to fill out. This form must not be older than one year. If renewing your medical, you may use the same medical form. Have your doctor complete the updates in the same medical form.They will need to sign with current dates. ​Medical records from your family doctor must include completion of these immunizations: - Measles, Mumps & Rubella \(MMR\) - Varicella \(Chicken Pox\) - Hepatitis B - Tetanus, Diphtheria, Pertussis - Polio​ - Annual Influenza Immunization - Mantoux Testing for Tuberculosis \(TB\); possible chest x-ray You can also complete this form through the [Seneca Medical Centre](https://www.senecacollege.ca/student-services-and-support/medical-centre.html) by emailing [Seneca Medical Centre](mailto:seneca.health@senecacollege.ca) using your Seneca email and including the following information in your message: First time patients, please fill out the appropriate registration form before visiting the Centre. - [international students](https://students.senecapolytechnic.ca/spaces/191/medical-centre/files/848/health-registration-form-international) - [domestic students and/or employees](https://students.senecapolytechnic.ca/spaces/191/seneca-medical-centre/files/14112/health-registration-form-domestic) - All previous immunization records 📌 Students who are not immunized due to **** medical or religious/conscience reasons must complete the Ministry approved exemption form: [Statement of Conscience or Religious Belief form](https://forms.mgcs.gov.on.ca/en/dataset/010-3042). This form must be signed and stamped by an Ontario Notary Public or Commissioner for Taking Affidavits. Students can use [Seneca Student Federation's free Legal Aid](https://ssfinc.ca/legal-aid). This exemption form must be included with all other documents submitted to Synergy. [**Annual Tuberculosis Self-Verification Form**](https://students.senecapolytechnic.ca/attachment?file=5wQ1mvMUkBK5aKb9w8giiQ%3D%3D) If you are not yet due for your annual TB 1-step, this form must be completed and submitted to SynergyGateway. Complete the [Annual Tuberculosis Self-Verification Form](https://students.senecapolytechnic.ca/attachment?file=5wQ1mvMUkBK5aKb9w8giiQ%3D%3D) follow the instructions. Add your information and signature to verify your TB status. NOTE: Some placement sites may require a more recent tuberculin skin test \(TST\) \(i.e. within the last 6 months\); check placement site requirements well in advance of your start date. **Flu Vaccine** Students can get their flu vaccine directly through [Toronto Public Health](https://www.tphbookings.ca/Default.aspx?PageID=11032) or your local pharmacy at no cost. Students must [schedule an appointment](https://tphbookings.ca/Default.aspx?PageID=11288) at their preferred location and should book early to guarantee a spot. Learn more about the [flu vaccine](https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/immunization/flu-influenza-vaccines/). **Please note:**students that do not receive the flu shot will need to leave placement immediately if there is a flu outbreak at field placement. Students will be permitted back once approved by Public Health. Students must make up missed hours/days. [Seneca's Medical Centre](https://students.senecapolytechnic.ca/spaces/191/seneca-medical-centre/home) The Seneca Medical Centre is located at Newnham Campus in A3000. The Centre's health care team includes registered nurses and medical doctors.While the Medical Centre is not a walk-in clinic, last minute appointment requests are accommodated as time permits. **Please call or email to get current appointment availability and process.** **Contact information** Email: seneca.health@senecapolytechnic.ca Phone: 437-312-0370 Fax: 416-493-8319 **International Students** [Health](https://students.senecapolytechnic.ca/spaces/276/school-of-ece-field-placement/wiki/view/14253/field-placement-international-students)[Insurance](https://students.senecapolytechnic.ca/spaces/276/school-of-ece-field-placement/wiki/view/14253/field-placement-international-students)**https://students.senecapolytechnic.ca/spaces/276/school-of-ece-field-placement/wiki/view/14253/field-placement-international-students** ## Attachments - [Seneca School of ECE - Annual TB Student Self Declaration.pdf](https://students.senecapolytechnic.ca/attachment?file=5wQ1mvMUkBK5aKb9w8giiQ%253D%253D) - [Seneca School of ECE - Medical Assessment Form v2254.pdf](https://students.senecapolytechnic.ca/attachment?file=Wg7qNUyreXTtz%252B750%252Bp3Xg%253D%253D)