Get Umd Immunization Form

This guide provides clear instructions for users on how to efficiently complete the Umd Immunization Form online. By following these steps, you will ensure that your immunization documentation is submitted correctly and on time.

Follow the steps to successfully complete the Umd Immunization Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete Section A with your personal information. Enter your last name, first name, University ID number, date of birth in mm/dd/yyyy format, and select your citizen status from the options provided. Additionally, include your local U.S. address, cell phone number, and email address. If you are under 18, ensure to provide parental consent by having a parent/guardian sign and date the designated area.
3. Move to Section B to provide your immunization records. Enter the dates for your MMR vaccinations, following the required guidelines of two doses with a minimum of four weeks apart. If you have individual vaccine records, provide the respective details for measles, mumps, and rubella along with the dates.
4. If you are living in on-campus housing, complete Section C by checking the appropriate box regarding the meningococcal vaccination and providing the date of administration.
5. In Section D, answer the TB screening questions honestly. If required, attach the laboratory report for the -based assay or chest X-ray, along with the corresponding dates.
6. Optional Section E allows you to provide additional vaccination information for your health. Document any other vaccines administered and their respective dates.
7. Finally, ensure that the designated health care provider has signed off on the form. Review the entire form for accuracy and completeness.
8. After completing all sections, save any changes you made, download a copy of the form, and print it if necessary to submit it. You can also share the completed form as required.

Complete your Umd Immunization Form online today to ensure a smooth registration process!