Step 4 - Health Questionnaire and Medical Clearance

You and your students need to complete Periodic Animal Contact Health Questionnaire (pdf). The last page, the Clearance Recommendation, will be completed by a physician.

  • Complete the first part – the Periodic Animal Contact Health Questionnaire
  • Take the Questionnaire/Clearance Recommendation to your personal physician.  You are responsible for any associated costs.  Students can make an appointment at the Student Health Center and the visit with a nurse should cost $20.
  • If you or your students have not received a tetanus booster within the last 10 years, you will need to receive a booster.
  • Once the last page has been completed, return it to Dr. Jeffrey Jasperse in the Natural Science Division.
    Pepperdine University
    24255 Pacific Coast Hwy
    Malibu, CA 90263-4321
    Phone: (310) 506-4949
    Fax: (310) 506-4785