Mandatory Immunization

Immunizations

The following immunizations ARE MANDATORY and must be documented with dates by the health care provider prior to registration.

 

Immunizations

  • *    Immunization Dates Measles, Mumps, Rubella MMR #1 and MMR #2  

 

  • *    TB Test (If positive a chest X-ray) Date of Test and Result,

 

  • *    Hepatitis B (bring documentation of first shot) #1 #2 #3

 

  • *    Tetanus/Diphtheria (TD Booster within last 10 years)

 

  • *    Meningitis shot OR signed waiver (applies to RESIDENT HOUSING STUDENTS only)

 

  • *      Name of Health Care Provider (Please Print): Date: Signature: Telephone: