Get Wcjc Meningitis Record Form

The Wcjc Meningitis Record Form is essential for students to document their bacterial meningitis vaccination status. This guide will walk you through the process of filling out the form online, ensuring you complete each section accurately and confidently.

Follow the steps to fill out the Wcjc Meningitis Record Form online.

1. Press the ‘Get Form’ button to acquire the Wcjc Meningitis Record Form and open it in your preferred online editor.
2. Begin by entering your student information, including your Student I.D., date of birth (formatted as MM/DD/YYYY), last name, first name, middle initial, enrollment term (semester and year), gender, student email address, and phone number.
3. Select either Option 1 or Option 2 based on your vaccination documentation. If you choose Option 1, ensure you attach a copy of your official immunization record signed by a health care provider, which must be in English or include a notarized translation, or provide a medical exemption affidavit. If you choose Option 2, fill in the fields required by a health care provider, including the date of vaccination, office stamp, health care provider’s name, address, phone, vaccine administered (MCV4 or MPSV4), and signature.
4. Review the statement asserting that you have read the bacterial meningitis vaccination requirements and certify that the provided information is accurate. This includes affixing your signature and the date.
5. If you are under 18 years of age, your parent or legal guardian must also sign the form, provide their printed name, date, and relationship to you.
6. Once all sections are completed, save your changes, then download, print, or share the form as needed.

Complete your Wcjc Meningitis Record Form online to ensure your vaccination documentation is submitted correctly.