Get Immunization Form - Stony Brook University - Stonybrook

Completing the Immunization Form for Stony Brook University is an essential step for students before joining the institution. This guide will provide clear and step-by-step instructions to help users fill out the form accurately online.

Follow the steps to complete the Immunization Form online.

1. Press the ‘Get Form’ button to access the Immunization Form. Once you have the form retrieved, open it in your preferred online document editor.
2. In the first section, input your student last name, first name, and middle name as displayed on your identification. Ensure that this information is accurate and clear.
3. Enter your Stony Brook ID number, followed by your home address, including street or apartment number, city or town, state or province, and zip code.
4. Fill in your home phone number, cell phone number, and email address. These details are crucial for the university to contact you if necessary.
5. For the emergency contact section, provide the name, relationship to you, and phone number of someone who can be reached in case of an emergency.
6. Indicate your country of residence if it is not the United States.
7. In Section I, list two dates when you received the MMR vaccine or attach a signed record from your practitioner. This is mandatory for compliance with health regulations.
8. Proceed to Section II, completing the required details for Measles, Mumps, and Rubella as stated. Follow the instructions carefully for each section, either providing vaccination dates, disease history, or blood test dates along with results as applicable.
9. Ensure that the physician completes the signature area in Section II and includes their stamp if required.
10. If you are under 18 years of age, ensure that a parent or legal guardian signs the permission for treatment statement. Record their relationship to you and date the form.
11. Before submission, make a copy of the completed form for your records. After verifying all fields are filled in correctly, you can submit the form to the Student Health Service.

Complete your Immunization Form online today to ensure your registration is processed smoothly.