Get Mandatory Immunization History Form - Florida Gulf Coast University - Fgcu
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How to fill out the Mandatory Immunization History Form - Florida Gulf Coast University - Fgcu online
Filling out the Mandatory Immunization History Form is essential for your enrollment at Florida Gulf Coast University. This guide will provide you with the necessary steps to ensure you complete the form accurately and effectively online.
Follow the steps to successfully complete your immunization history form online.
- Press the ‘Get Form’ button to download the document and open it for editing.
- Begin by entering your personal information. Fill in your last name, first name, middle initial, university ID number, date of birth, age, permanent address, city, state, zip code, and phone number.
- In the vaccination section, start with the MMR vaccines. Input the dates of your vaccinations, ensuring that the first vaccine was administered after 12 months of age and after 1969, with the second dose at least 28 days later.
- Continue with the separate entries for Measles, Mumps, Rubella, Hepatitis B, and Meningococcal vaccines. For Hepatitis B, indicate whether you are completing a series of three vaccinations or opting to sign the waiver.
- For the Meningococcal vaccine, indicate which type was given from the available options and document the date.
- At the end of the required section, if you choose to decline the Hepatitis B or Meningitis vaccines, check the corresponding box and provide your signature.
- For the optional vaccinations list, fill in the dates for Tetanus Diphtheria, Hepatitis A, Varicella, and HPV vaccines, ensuring to include the laboratory results required if proof of vaccination is submitted by titer.
- Once all required fields are completed, ensure your physician or authorized signature is obtained at the bottom of the form along with their stamp, otherwise the form will not be accepted.
- Finally, after confirming all information is accurate, save your changes, and prepare to either download, print, or share your completed form as needed.
Complete your documents online to ensure a smooth enrollment process at Florida Gulf Coast University.
Contact the Immunization Section 1-877-888-7468. Immunization@FLHealth.gov. 850-922-4195. Florida Department of Health. Immunization Section. 4052 Bald Cypress Way, Bin A11. Tallahassee, FL 32399-1719.
Fill Mandatory Immunization History Form - Florida Gulf Coast University - Fgcu
If you need to make an immunization appointment, please call . Student Health Services at FGCU manages the immunization documentation process. You need to log in to your FGCU Eagle Access with your user name and passport before submitting your immunization records. Immunization documents can be submitted in your FGCU Student Health Portal. Completed personal immunization record, such as the DH 686 Form. 1. The Form DH 680, Florida Certification of Immunization, must be used to document receipt of immunizations required for entry and attendance in Florida schools. All graduate students in campus-based programs must submit proof of immunizations. Log into your my.uwf. Prior to registration, ALL new students accepted for admission must submit a completed UCF Immunization Health History mandatory form. Completed personal immunization record, such as the DH 686 Form. 1.
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