Medical Assessment | School of ECE Field Placement | Seneca Students

Please download, print and bring this Seneca School of ECE Medical Assessment Form 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 by emailing Seneca Medical Centre 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

• domestic students and/or employees

• 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. 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. This exemption form must be included with all other documents submitted to Synergy. 

Annual Tuberculosis Self-Verification Form

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 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 or your local pharmacy at no cost. Students must schedule an appointment at their preferred location and should book early to guarantee a spot. Learn more about the flu vaccine. 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

Medical Appointments 

The Seneca Medical Centre team is available to assist you virtually Monday to Friday, 8 a.m. to 4 p.m. with:

Booking an appointment

To book your appointment, please contact the Seneca Medical Centre clinic either by email at seneca.health@senecapolytechnic.ca or by phone at 437.312.0370, and provide your name, contact number and Seneca ID.

Rescheduling or cancelling an appointment

To reschedule or cancel your appointment, please notify the Seneca Medical Centre at least 24 hours in advance, otherwise you will be charged a $50 no-show fee.

Walk-in/same day appointment

Please call the Seneca Medical Centre prior to visiting the clinic if you are considering a walk-in/same day appointment.

Our contact information

Email: seneca.health@senecapolytechnic.ca

Phone: 437.312.0370

Fax: 416.493.8319