Get Immunization And Medical Record Request Form - Southeastern ... - Selu
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Immunization And Medical Record Request Form - Southeastern online
Completing the Immunization and Medical Record Request Form efficiently will help you obtain your medical records with ease. This guide provides step-by-step instructions to assist you in filling out the form accurately.
Follow the steps to successfully complete your request:
- Press the ‘Get Form’ button to acquire the form and open it for editing.
- Fill in your personal details. Provide your full name, phone number, and university identification number (W#).
- Enter your date of birth and indicate your first semester at Southeastern (for example, Spring ‘06). This information helps in retrieving your records.
- Indicate whether you have been a patient at the Health Center by selecting ‘Yes’ or ‘No’. This field is crucial, so please make your choice carefully.
- Select the type of medical information you are requesting by checking the appropriate boxes for Immunization Record, Lab Reports, Consultation Notes, and others. You can also specify other types of records in the space provided.
- Indicate your preferred method of receiving your records by circling 'faxed', 'mailed', or 'in hand'. Provide the necessary contact details accordingly, including the fax number or mailing address.
- Sign and date the form to validate your request. Ensure your signature is clear for processing.
- After completing all sections, save your changes. You can download, print, or share the form as needed.
Complete your Immunization and Medical Record Request Form online for a swift and hassle-free experience.
To send your transcripts to Southeastern, you can use the designated submission guidelines outlined on their website. The Immunization and Medical Record Request Form - Southeastern ... - Selu may provide answers on how to include your academic records efficiently. Ensure that you send your transcripts securely and include all necessary information to facilitate processing. For any further questions, you can contact their admissions office directly.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.