ABSTRACTObjective: Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among IHEs in Indiana in order to inform public health action. Methods: IHEs in Indiana were identified and included in the study if they offered on-campus housing and had a dedicated student health center. Phone surveys were administered in September 2015 to each institution, inquiring about current immunization documentation policies and practices, disease surveillance capacity, and use of statewide electronic reporting systems. Additionally, IHE websites were searched to identify immunization documentation requirements for matriculating students. Results: Surveys were completed for 33 of 38 eligible IHEs. Twenty-three (70%) IHEs reported that student immunization records are entered into an accessible electronic system or database. Matriculating student immunization requirements were identified for 32 institutions. Of these, 22 (69%) required a physician-signed proof of immunization. No IHEs reported documenting historical immunizations in the statewide electronic immunization system and three IHEs (9%) reported utilizing the state electronic disease surveillance program. Conclusions: Immunization documentation practices vary among IHEs in Indiana and use of statewide immunization and disease reporting systems is minimal. Robust utilization of immunization and disease surveillance systems has been shown to improve public health response to communicable disease outbreaks. Improving mutual understanding of policy and practice between health departments and IHEs could improve the ability to respond to public health challenges.