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 and meningitis requirements, please do that before completing and submitting this form.
For the best experience use a non-mobile device.
- 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.
Student Life
University at Buffalo
4350 Maple Rd
Amherst, NY 14226
Phone: (716) 829-3316; Fax: (716) 829-2564
