Immunization record? Check. Meningitis and flu shots? Check. But did you have that talk about sex, drugs and alcohol?

Going to college is a big step into the adult world — but it’s also the first exposure to the germs that come with living in close quarters, as well as the social temptations that come with it.

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Keeping healthy during the college years can be a challenge.

“The great thing about college is that it happens during adolescence,” said Dr. Lonna Gordon, a specialist at Mount Sinai Adolescent Health Center in New York City. “It’s a time for exploration and learning about new things…but that can pose some health risks and harm, if you are not careful.”

'What if I am sick, who will take care of me?'

Ingrid Rizo, a single mom from Roxborough, Colorado, says she thinks she has “things covered” as she prepares to send her daughter Lina off to the University of Missouri to study journalism in the fall.

This week they have been “scurrying around” making sure all her immunizations are current.

Rizo has also had conversations with Lina about substance abuse, pregnancy risk and STDs. “Before she leaves, I’ll probably buy a box of condoms and make sure to replace them when she is back for Christmas,” she said. “But I don’t want to know if they’ve been used!”

Rizo still worries.

“I'm torn between my pride in her and my desperate sadness about moving her to 10 hours away,” Rizo, 48, told NBC News.

“I was always a little bit uncomfortable about her going so far away,” she said. “One day she said to me, ‘what if I am sick, who will take care of me?’”

Ingrid Rizo and her college-bound daughter Lina Krueck at high school graduation in Colorado. Ingrid Rizo

One of her biggest concerns is that the college health center doesn’t take the family’s health insurance and Lina is a triathlon athlete. “Cycling, these kids are wheel-to-wheel and there are a lot of accidents.”

Lina is also native American, and Rizo, an adoptive mom, worries about the “micro-aggressions” that come with being a minority student in a new environment.

“I know I am thinking about all the worst scenarios,” she said. “Legitimately, I think her health will be fine. …And Lina is definitely not as nervous as I am.”

“But when she is on her own, my eyes and disapproval will not be there,” she said. “Who knows if it will work?”

'Getting good sleep can help'

Beyond social temptations, a college career can be derailed by poor nutrition or lack of sleep, say experts.

Kate Carter, a 34-year-old mother from New Hampshire said her step-daughter dropped out of college after three emergency room visits for chest colds and untreated urinary tract infections.

“She was used to me cooking daily and was suddenly on her own,” said Carter. “I doubt she was unique in that she ignores symptoms until she's very sick.”

Libby Caruso, director of the health center at The College at Brockport in New York, says, “Getting good sleep can help … all around.”

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“They’ll be less susceptible to infection and more likely to make better decisions,” said Caruso. “Sleep amount and quality has diminished in all of us, college students, especially.”

With all this in mind, here’s a checklist so your student can have the healthiest college experience:

Immunizations:

Primary series childhood vaccines: measles, mumps and rubella; all three hepatitis B series; polio series. “Most colleges want those for sure, and typically school districts require them,” said Mount Sinai’s Gordon. “And most parents do a good job of seeing they are completed.

Tdap booster for diphtheria, tetanus, and pertussis has been added because immunity to pertussis or whooping cough wanes with age. “Sometimes that slips by the wayside,” Gordon said.

“We don’t want an outbreak of pertussis on a college campus,” said Gordon, “While most adolescents will do fine — a five or 10-day bad cold that will keep you out of class — those with problems of the heart and lungs may end up hospitalized.”

Meningitis type B vaccine (two different shots to protect against two strains) “Bacterial meningitis is fatal and it’s a huge risk in college,” said Gordon. The disease, which has spiked recently, is spread by droplets in the air and close contact with oral secretions — shared toothbrushes and utensils, sneezing, coughing and kissing. “Anything that causes saliva on an object.”

Don’t forget a flu shot, recommended now for all ages. Last winter, The College at Brockport reported 375 cases of the flu, the biggest outbreak in decades even though they offer immunization for free.

This year, the college hopes to “get it right,” said health center director Caruso, with clinics in the student union, library, dorms and athletic center. “It’s really helpful if parents encourage their kids to be immunized and they can have more influence than they sometimes think.”

Social hazards:

More than 1,800 college students die each year from alcohol-related accidents, according to the National Institute of Health. Students: Understand your alcohol tolerance. Always have a designated driver. Don’t feel pressured to consume more than you want. “And remember, underage drinking is a crime,” said Gordon.

Marijuana may be legal in some states, but under federal law it’s illegal. The drug can impair the brain’s executive function or decision-making, which is not fully developed until the mid-20s. “Because it doesn’t affect the ability to walk and talk, a lot of kids don’t perceive they are high,” said Gordon. “You need to be able to plan ahead in college: take exams, work, pay bills, do laundry.”

Sexually-transmitted diseases:

Human papilloma virus (HPV) is the most prevalent and has been linked to cancers in both men and women. Three vaccines are available recommended as early as age 9, but can be given later, even if already exposed to the virus. “Long-term studies show they are safe and effective,” said Gordon.

Chlamydia, gonorrhea and even syphilis are on the rise. Students: Be screened for STDs regularly, especially before a new relationship. Parents: Have a “holistic” conversation with your child about STDs and how they are transmitted. “Fear tactics don’t work,” said Gordon. “They should be informed about barrier methods and access to emergency contraception.

Know your medical history: At 18, freshman are legally adults and colleges don’t have to share medical information with parents. “This can be a challenge in emergency situations,” said Gordon. “But if you go to the doctor, you can invite anyone into the conversation.”

“For kids with chronic medical conditions, its important to have a sense of student health for urgent care needs, but perhaps also having a doctor in the area to collaborate [with college doctors].”