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NAME (PRINT) SSN HEPATITIS B IMMUNIZATION FORM ILLINOIS COLLEGE OF OPTOMETRY / ILLINOIS EYE INSTITUTE It is my opinion that should and is physically able to receive the Hepatitis B (HBV) vaccine.

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Submit electronically via your Secure Health Portal, OR. Mail to Campus Box 2540, Normal, IL 61790-2540, OR. Fax to Student Health Services at (309) 438-5205, OR. Bring in person to the Student Services Building, Student Health Services reception desk when you are on campus next.

To bill, use the ICD-9 diagnosis code for contact with or exposure to communicable disease, other viral diseases (ICD-9 code V01. 7) along with the appropriate CPT code (90746 for hepatitis B vaccine or 90632 for hepatitis A vaccine) plus the appropriate CPT administration code (90471 for immunization administration).

No person shall attend a post-secondary educational institution without presenting proof that he or she has received such immunizations against preventable communicable diseases as the Department shall require by rules and regulations promulgated pursuant to this Act and "An Act in relation to the prevention of certain ...

Provides that the Department of Public Health shall adopt a rule requiring students, upon entering the sixth grade of any public, private, or parochial school, to receive the human papillomavirus (HPV) vaccination and requiring confirmation that the student has completed the series of HPV vaccinations upon entering the ...

Based on Illinois State Law and University Policy, all newly admitted and re-admitted students to Illinois State University are required to provide proof of immunity for tetanus, diphtheria, pertussis, measles, mumps, rubella and meningitis.

No person shall attend a post-secondary educational institution without presenting proof that he or she has received such immunizations against preventable communicable diseases as the Department shall require by rules and regulations promulgated pursuant to this Act and "An Act in relation to the prevention of certain ...

Illinois state law requires certain immunizations for children and adults enrolled in child care, school, or college. State law also mandates immunizations for adults in specific fields of work (healthcare).

Hepatitis B 6th – 12th 3 doses of Hepatitis B vaccine or two doses Adult Recombivax-HB vaccine for ages 11-15. Lead Screening Lead screening is a required part of the health examination for children age 6 months to 7 years prior to admission to kindergarten or first grade.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232