Get Important! This Form Is Due By July 1, 2013 - Vpul Upenn

Completing the IMPORTANT! THIS FORM IS DUE BY JULY 1, 2013 - Vpul Upenn is essential for ensuring your immunization records are submitted accurately and on time. This guide will provide you with step-by-step instructions to fill out this important form online.

Follow the steps to complete your immunization form online:

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Fill in your personal information in the designated fields: Last Name, First Name, Penn ID, Email, Cell or other contact phone number, and Date of Birth.
3. Provide details of your Hepatitis B vaccinations, including the date of each dose using the format Month/Day/Year. Remember to attach any relevant titer documentation.
4. Complete the Measles, Mumps, Rubella section by entering the relevant dose dates or checking the illness documentation, if applicable.
5. For Meningococcal vaccination, indicate the last dose received since the age of 16. Make sure to select the correct vaccine type and complete the required sections based on your housing situation.
6. Fill in the Tetanus-Diphtheria and Pertussis (Tdap) details, ensuring you provide proof of Tdap immunization.
7. Complete the Varicella (Chicken Pox) section by entering the dates of your vaccinations or documenting your history of illness, as required.
8. Complete the Tuberculosis Screening section acknowledging that only specific submission methods are accepted.
9. Enter your Health Care Provider Information, ensuring the signature, title, and contact details are correctly filled in.
10. Review all information you have entered for accuracy before submitting. Once verified, submit the form and any necessary documentation online.
11. You will then need to fax the completed worksheet and all related documents to the Student Health Service as instructed.
12. Finally, make sure to save your changes, download, print, or share the form as necessary for your records.

Complete your immunization documentation online today to ensure compliance and avoid any delays!