Get Form E: Immunization/titer Results - Student Services - Studentservices Tu

This guide provides comprehensive instructions on how to complete the Form E: Immunization/Titer Results necessary for student services. Following these steps will ensure that your immunization documentation is submitted accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Use the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Begin by filling in the class of study from the available options: COM, COP, GSOE, MSPAS/MPH, or MPH.
3. Enter your full name in the designated field and indicate your gender by checking either 'M' or 'F'.
4. Provide your date of birth in the format: MM/DD/YYYY.
5. Items 1-5 require that you attach a copy of all immunization records and the most recent lab/titer results.
6. Complete the hepatitis B surf antibody (Hepatitis B Surf Ab, QN) section, including the titer date and results.
7. If the titer results indicate negativity, you should note the dates for the hepatitis B series vaccinations accordingly.
8. For hepatitis B carriers, provide the necessary blood tests and record their results.
9. Fill in the measles (rubeola) antibody section, ensuring to follow the instructions on vaccination if results are negative or inconclusive.
10. Proceed similarly with filling in the sections for mumps, rubella, and varicella antibodies, following the same protocols for vaccination if required.
11. Complete the tetanus diphtheria acellular pertussis (Tdap) booster date.
12. Record tuberculosis (TB) screening details, including the placement and reading dates of the TB skin test and the results.
13. Gather and submit all required additional documents, including the healthcare provider's signature, printed name, and address.
14. Review all sections of the form for accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete your Form E and submit it online to ensure your immunization requirements are met.