Get Cnhp Immunization Form (6 Total Pages) - Drexel University - Drexel

This guide provides comprehensive instructions on filling out the CNHP Immunization Form for Drexel University students. By following these steps, users can ensure that their immunization records are accurately submitted and compliant with university requirements.

Follow the steps to accurately complete the CNHP Immunization Form.

1. Press the ‘Get Form’ button to obtain the CNHP Immunization Form and open it in your preferred editor.
2. Complete the student information section at the top of the form. Enter your last name, first name, middle initial, Drexel University ID, and select your program from the provided list.
3. Move to the Tuberculosis Form (Page 1). Fill out the date given and date read for the 2-Step PPD Tuberculin Skin Test and record the results, indicating if it is negative or positive. If positive, provide the date and result of the chest X-Ray.
4. Proceed to the Tdap Form (Page 2). Document the date the Tdap vaccination was given, ensuring it is within the last 10 years. Include a health care examiner's statement and signature.
5. On the MMR Form (Page 3), enter the vaccination dates for the first and second doses. If applicable, include the results and dates of the laboratory tests for rubeola, mumps, and rubella titers.
6. Move to the Varicella Form (Page 4). Note the vaccination dates for the first and second doses. If applicable, attach the ELISA titer results for verification of immunity.
7. On the Hepatitis B Form (Page 5), provide the dates of the first, second, and third doses of the Hepatitis B vaccine. Document the date titer completed and attach results of the laboratory test.
8. Complete the Physical Examination and Student Statement Form (Page 6). Ensure the health care examiner completes the physical examination section, including their name, license number, and signature.
9. As a student, confirm that all information is accurate and that you have attached required titer copies. Sign the statement to acknowledge understanding of the form's importance for starting the clinical component.
10. Finally, save your changes, and either download, print, or share the completed form as needed.

Submit your completed CNHP Immunization Form online to ensure compliance with Drexel University's health requirements.