Once a U.S. college soccer commitment is done, two sets of medical paperwork usually arrive before summer. One comes from the university's Student Health office and covers immunizations and a tuberculosis (TB) check. The other comes from the athletics department's sports medicine staff and covers the preparticipation physical evaluation (PPE), the sickle cell trait test and the school's own forms. Finishing one set rarely gets a player onto the practice field, so the simplest way to start preseason on time is to treat them as two separate deadlines.
This guide covers what each set of forms is, when it is due and how to ask the school about it. Insurance enrollment and waivers are covered in our international student health insurance guide. How report dates are set is covered in preseason report dates, and the full pre-departure checklist is in the parents' 90-day pre-departure plan. We won't repeat those here. This is general information, not medical advice. Whether a vaccine or test is needed, and when, is a decision for a doctor together with the university's Student Health office and athletic trainers. The facts below were checked against official sources, including the CDC, NCSL and the NCAA, as of October 2026.
Definition (answer first): In U.S. college soccer, the immunization and TB records required for enrollment (handled by Student Health) and the pre-participation medical clearance required by the NCAA and the school (the PPE, handled by athletics) are separate processes. Completing only one of them often means a player still cannot practice.
Conclusion: two tracks, and you need both before the first practice
The short answer is to split the paperwork into two tracks.
- Track 1: Student Health. This covers immunization records and a TB risk check, which may be a questionnaire or a test. Requirements come from state law and university policy. Missing items can trigger a hold on course registration or move-in.
- Track 2: Athletics sports medicine (the PPE). This covers the pre-participation exam, medical and surgical history, the sickle cell solubility test and school-specific forms. A player cannot practice or train until cleared.
The two tracks have different offices and different deadlines. Finishing one does not mean the other is done.
Side-by-side comparison
Both tracks are "health paperwork," but their purpose, office and consequences differ. The table below is a general picture. Details vary by school.
| Item | Student Health | Athletics sports medicine (PPE) |
|---|---|---|
| Purpose | Preventing infectious disease on campus (state law and school policy) | Confirming the athlete can participate safely (NCAA rules plus school policy) |
| Typical documents | Immunization record form, TB questionnaire or test result | Health and surgical history, PPE, sickle cell solubility test, consent forms |
| Typical deadline | Before enrollment (a set date before term) | Before the first practice or workout |
| If missing | Possible hold on registration or housing | No practice, competition or conditioning |
| Who to contact | Student Health / Health Services | Athletic trainers and the team physician |
| Insurance overlap | Student insurance enrollment or waiver deadlines are often nearby | Proof of insurance is often requested |
Track 1: immunizations and TB (set by state and school)
Which vaccines are required depends on state law and university policy. There is no national list, so always check the Student Health page of the school the player is attending.
Requirements vary by state
NCSL's state-by-state summary, updated in February 2025, reports that:
- At least 34 states plus Washington, D.C. require some vaccine for college students.
- At least 22 states require a meningococcal vaccine, mostly for students living on campus.
- At least 23 states require measles vaccination, mostly through MMR.
Texas requires meningococcal vaccination for students under 22, and New York requires proof of MMR immunity. Universities often add their own requirements on top of state law. Use NCSL as background and follow the university's own list.
Common items (examples)
| Item | Typical request | Reference |
|---|---|---|
| MMR (measles, mumps, rubella) | Two doses, or proof of immunity such as a titer | CDC recommends two MMR doses at least 28 days apart for post-high-school students without evidence of immunity |
| Meningococcal ACWY (MenACWY) | Often required for students in residence halls | CDC recommends a dose at 11–12 with a booster at 16 |
| Meningococcal B (MenB) | Often not required (school-dependent) | CDC uses shared clinical decision-making for ages 16–23 |
| Tdap | Some schools want a dose within a set number of years | State and school dependent |
| Varicella, hepatitis B | Some schools want dose history or a titer | State and school dependent |
| TB | Risk questionnaire, with a test if indicated | Some schools require testing after arrival |
Some schools set requirements based on whether the student lives on campus, so check them alongside housing decisions (first-year dorms and homestays). MenACWY and MenB are different vaccines, and a MenB dose does not satisfy a MenACWY requirement.
Gaps between Japanese records and U.S. forms
Japanese vaccine names and combinations don't always line up with U.S. form fields. In general:
- Japan's routine schedule uses an MR (measles-rubella) vaccine.
- Mumps is an optional vaccine in Japan.
- Meningococcal vaccines are not part of the routine schedule.
- The second-phase dose given around ages 11–12 is DT (diphtheria-tetanus), without a pertussis component.
Don't decide on your own which items are missing. Ask a doctor to compare the school's form with the Maternal and Child Health Handbook (boshi techō).
How records are submitted
Many universities ask for a school-specific form (often a PDF) signed by a physician, or for records uploaded to a Student Health portal. Whether a copy and translation of the boshi techō will be accepted is up to each school, so ask before you start.
Track 2: the PPE and medical clearance (athletics)
The NCAA requires a mandatory medical examination, the PPE, before student-athletes in their first season participate in practice, competition or out-of-season conditioning.
Key NCAA points
The NCAA Sports Medicine Handbook (26th edition, 2026) says:
- Athletes in their initial season, transfers and tryouts must complete the exam before any practice, competition or out-of-season conditioning. This comes from Division I, II and III bylaws.
- The exam must take place within six months before initial participation. In later years, the school must obtain an updated medical history within six months before each academic year.
- A licensed physician must administer or supervise it, and this can be a team or personal physician. An independent nurse practitioner licensed in the state may also perform it.
- Division II tryouts have an exception that allows one year instead of six months.
The handbook says the ideal timing is four to six weeks before preseason. Some schools hold the PPE the day before or the day of the first practice. In that case, any follow-up test can delay clearance.
What's inside varies by school
The content of the PPE is set by the school. Typical pieces include:
- a health history questionnaire
- uploads of past injury and surgery records
- a concussion baseline test
- a copy of the insurance card
- an on-campus exam appointment
Some schools send forms for a doctor in Japan to complete, while others run the PPE on campus after arrival. Don't assume a Japanese school health check replaces the PPE.
Prior injuries or surgery
If the player has had surgery or MRI scans, ask the treating doctor for an English summary before departure. It should include the diagnosis, surgery date, procedure and current status. Missing records sometimes keep players out of conditioning longer than necessary. We cover injuries and eligibility in injury, redshirt and medical reality.
Sickle cell trait: the solubility test
As part of the PPE, the NCAA requires either a sickle cell solubility test or documented results from a previous solubility test.
Why the test exists
According to the NCAA, sickle cell trait is not the same as sickle cell disease, and most people with the trait live healthy lives and compete. In rare cases, very intense exercise can cause problems. The purpose of the test is awareness, so that coaches and athletic trainers can take precautions in training. The NCAA states that there is no reason athletes with the trait shouldn't be allowed to compete.
Newborn screening may not count
In a January 2026 explainer, the Vermont Department of Health described the NCAA's clarification that only results from a sickle cell solubility test satisfy the requirement. Newborn screening is a different test and is not accepted. If the player has older test results from Japan, whether they came from a solubility test is a separate question.
Before doing anything, ask the athletic trainer: "Can we submit a solubility test result from Japan, or will the test be done during the on-campus PPE?" Also ask a doctor whether a Japanese clinic can run the same type of test.
Is there an opt-out under current rules?
Older information online mentions signing a waiver to decline the test. The 2026 Sports Medicine Handbook describes only two options: take the solubility test or provide documented prior results. We could not find an opt-out in the current text. Confirm how the school handles it.
If you'd like help organizing post-offer medical paperwork and preseason dates school by school, you can send us your situation. We don't make medical decisions or promise clearance outcomes.
Timeline (parent calendar)
Starting medical paperwork about three months before the summer departure leaves enough buffer. The example below assumes preseason starts in mid-August.
90–60 days before departure
- Find the Student Health immunization form and the athletics forms in the admitted-student portal.
- Book an internal medicine or travel clinic appointment in Japan.
- Keep the boshi techō on hand.
45–30 days before departure
- Work through vaccines, blood work and form completion with the doctor.
- Prepare translations in parallel if needed.
- Confirm with the athletic trainer how the sickle cell test will be handled.
14 days before departure through arrival
- Confirm that portal submissions show as complete.
- Check that no registration hold remains.
- Book any required TB test or campus PPE.
- Line these steps up with visa and travel tasks so dates don't collide (visa and move prep after the offer).
Arrival to report date
- Complete the on-campus PPE.
- Don't practice or lift until cleared, and follow the school's rules.
- For banking and phone setup, see the first-month U.S. setup guide.
From boshi techō to the school's form (copy-ready steps)
The boshi techō is the key source record for vaccinations. Schools usually still want their own form completed and signed by a physician, so work in this order:
- Prepare the original boshi techō and copies of its vaccination pages.
- Print the school-specific forms for both Student Health and athletics.
- Have a doctor review the boshi techō alongside the forms, then enter the vaccine names and dates and sign.
- If anything is missing, discuss catch-up doses or titer testing with the doctor.
- Ask the school whether a separate English certificate is required.
- Keep copies of the submitted forms and screenshots of the portal's completion screens on the family side.
If the player is under 18, some forms include a parent or guardian signature line. See under-18 guardianship and housing.
Costs (examples, not quotes)
Costs depend on the mix of catch-up vaccines, titers, the solubility test, physician form fees and translation fees. These vary widely by provider, so we don't list amounts here. Get estimates from both Japanese clinics and the U.S. campus before deciding where to do each step. In Japan, optional vaccines and paperwork are often not covered by insurance.
Six common stumbles
Most stumbles come from mixing up the two tracks or not confirming details.
- Assuming MenB covers MenACWY. They are different vaccines.
- Emailing a copy of the boshi techō but never completing the portal. Submit in the format the school asks for.
- Finishing insurance first and leaving the PPE for later. That can keep a player out of practice.
- Treating newborn screening as sickle cell documentation. The requirement is for a solubility test result.
- Having no English records of prior surgery. This often delays clearance.
- Missing a registration hold. Incomplete Student Health forms can block class registration.
The NextPitch view
NextPitch focuses on fit, not famous names. How smoothly a school's international office, Student Health and sports medicine staff work together is part of that fit. Missing preseason because of late medical paperwork is a preventable setback. For the full picture of U.S. college soccer, start at our college hub.
Once the player is enrolled, see FERPA and parent access for what parents can see of grades and bills.
FAQ
Is Japan's routine vaccine schedule enough? It depends on the school and state. MR versus MMR, mumps and meningococcal vaccines often create gaps. Have a doctor compare the school's form with the boshi techō.
Is the meningococcal vaccine required? It depends on the state and school. Many require MenACWY for residence hall students. MenB is a separate vaccine.
Can a Japanese school health check replace the PPE? Don't count on it. The NCAA PPE is a pre-participation exam administered or supervised by a physician, and schools have their own forms and procedures.
Does everyone take the sickle cell test, and does a positive result mean no playing? The NCAA requires athletes new to sport at a school either to take a solubility test or to provide documented prior results. The NCAA says the trait is no reason to restrict participation. The aim is staff awareness and training precautions.
Can the TB test be done in Japan? Some schools accept results from Japan and others require testing after arrival. Ask Student Health.
Insurance or immunizations first? Work on both at the same time, since the deadlines are usually close together. See the insurance guide for that process.
Next step
If you'd like to map post-offer medical paperwork and preseason timing school by school, apply for a consultation. We can't make medical decisions or promise clearance or playing outcomes, but we can help you plan the order of steps so you meet each deadline.