Get Annual College Immunization Status Report - State Of New Jersey - Newjersey

Filling out the Annual College Immunization Status Report is an essential step for institutions of higher education in New Jersey to ensure compliance with immunization requirements. This guide provides clear instructions on how to effectively complete the form online, making the process straightforward for everyone involved.

Follow the steps to complete your immunization status report.

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. Begin by entering the name of your institution of higher education in the designated field.
3. Next, specify the report year by filling in the appropriate space.
4. Input the address of your institution, including town/municipality and zip code.
5. Provide the total fall enrollment head count for your university or college.
6. List the names and titles of the individuals responsible for implementing immunization requirements, along with their telephone numbers.
7. Record the titles and names of the individuals responsible for maintaining immunization records and their telephone numbers.
8. For the Measles, Mumps, and Rubella requirement section, carefully input the number of incoming students, those in non-degree status, students born before 1957, and other specified categories.
9. Calculate the number of students subject to the MMR regulation and fill in the numbers for students meeting the MMR requirement, provisional status, medical exemptions, and religious exemptions.
10. Inquire whether your institution offers immunization services for the MMR vaccine and provide the name of the contracting organization if applicable.
11. Follow the same process for the Meningococcal Meningitis Education and Vaccination Requirement and the Hepatitis B Vaccine Requirement sections, entering the required data as prompted.
12. Complete the final section by entering the name or title of the person reporting and submitting the report, their signature, telephone number, and the date submitted.
13. Once all fields are completed, save your changes, and choose to download, print, or share the form as necessary.

Complete and submit your Annual College Immunization Status Report online today.