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IMMUNIZATION FORM Name PLEASE PRINT (Last) ID: (First) Z Birthday / MONTH Gender: M F Health Services DeKalb, Illinois 60115-2828 815-753-1311 www.niu.edu/healthservices / DAY Term Entering NIU: YEAR.

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How to fill out the Niu Immunization online

Completing the Niu Immunization form is a crucial step for students enrolling at Northern Illinois University. This guide provides clear, step-by-step instructions to help users effortlessly complete the online form.

Follow the steps to successfully fill out the Niu Immunization form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by providing your personal information. Fill in your last name, first name, and birthday in the designated fields. Ensure that all details are clearly printed.
  3. Next, indicate your gender and the term you are entering NIU by selecting the appropriate options.
  4. In the required immunization section, provide the month, day, and year for each dose administered. Fill in the fields for DPT, Tdap, and MMR, ensuring you accurately document every vaccination.
  5. If applicable, provide the disease date or titer date for rubella and mumps, attaching a copy of the titer where required. Remember that a diagnosis of disease is not acceptable.
  6. Complete the fields for the health provider's information, including their signature, address, and phone number to verify that immunizations were given.
  7. Move to the recommended immunizations section and check any additional immunizations as required by your specific program. Document the relevant dates.
  8. If you are under 18 years of age, ensure that a parent or guardian signs the consent statement for treatment and provides their printed name and date.
  9. Finally, review all entered information for accuracy and completeness. You can then save changes, download, print, or share the form as needed.

Complete your immunization documentation online today for a smooth enrollment process.

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About COVID-19 Vaccination Requirements NIU strongly encourages every Huskie to be vaccinated and up to date on their vaccines. Many clinical placements, internships and practicums are requiring participating students to be fully vaccinated.

Based on Illinois State Law and University Policy, all students taking course work that has been coded as 'On Campus' by the Academic Deparment are required to provide proof of immunity for Tetanus, Diphtheria, Pertussis, Measles, Mumps, Rubella and Meningitis.

Code 694) requires all domestic and international students have the following vaccines: Three (3) vaccines that contain tetanus/diphtheria/pertussis, one of which must be Tdap vaccine. The last dose of vaccine must be within 10 years.

Document Submission: 60115-2828 Or • Bring into Health Services Building, Immunization Compliance office, 2nd floor. Your records are not complete until they have been reviewed and verified by the Immunization Compliance office. All records must be in English and legible.

If you're new to NIU, you may be required to take placement exams, which provide information that helps determine which NIU courses you should take. You should take any required exams as early as possible.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232