Ensure that your immunizations are up to date. You must submit this form annually if you are a student in a health-related professions program.
If you did not yet read the informational Immunization Requirements in the Student Services Gateway, please do that before completing and submitting this form.
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- This form requires the signature or stamp of your health care provider.
- Your health care provider must provide the requested information on this form. Students are not allowed to fill it out themselves.
-This form must be completed in English.