Get Immunization Form 121

Filling out the Immunization Form 121 is a critical step in ensuring compliance with New Hampshire's immunization requirements for students. This guide will walk you through the process of completing the form online, providing detailed instructions for each section to make the process straightforward and user-friendly.

Follow the steps to complete the Immunization Form 121 online

1. Click the 'Get Form' button to obtain the Immunization Form 121 and open it in your preferred online editor.
2. Start with the personal details. Enter the student's last and first name, date of entry, and date of birth in the respective fields provided. Ensure the dates are formatted correctly as MM/DD/YYYY.
3. Proceed to the required immunizations section. Enter the date of each required vaccination taken, ensuring that you have documentary proof attached where necessary. This may include records signed by a healthcare provider.
4. Answer the question regarding the history of disease. Indicate 'Yes' or 'No' as appropriate and provide details of the antibody titers if applicable.
5. Complete the recommended immunizations section by noting the dates for any additional vaccines that are suggested, such as hepatitis B or meningococcal vaccines.
6. Address the tuberculosis status screening section by answering the two questions regarding active tuberculosis symptoms and risk group status. Provide responses and follow up with necessary evaluations as indicated.
7. In the healthcare provider section, ensure that the provider's name and contact information are filled in, along with the date. This must be signed by the health care provider.
8. Once all information is accurately filled in, save your changes. You can download, print, or share the completed Immunization Form 121 as needed.

Complete your Immunization Form 121 online today for a hassle-free enrollment process.