Get Mandatory Immunization Record Form - Capital University Center - Cucpierre

Filling out the Mandatory Immunization Record Form is a vital step for students attending Capital University Center. This guide will provide clear and detailed instructions on how to complete the form online, ensuring you have all the necessary immunization documentation.

Follow the steps to complete your immunization record efficiently.

1. Press the ‘Get Form’ button to access the Mandatory Immunization Record Form and open it for editing.
2. Begin by entering your personal information in Section A. Provide your full name, including your last name, first name, and initials. Include your date of birth in the format of Month/Day/Year.
3. In Section B, document your mandatory immunizations. You must enter the dates of your first and second MMR (Measles, Mumps, Rubella) vaccinations. Ensure each date is formatted as Month/Day/Year.
4. Alternatively, if you have titers showing immunity, fill out the titer dates for Measles, Mumps, and Rubella, including a positive result status and attach lab results if available.
5. In Section C, include the name and address of your clinic or physician who administered the immunizations. A signature from the physician or an authorized individual is necessary, along with the date of signature.
6. Review the completed form for accuracy and completeness, ensuring all mandated information is included. Incomplete forms may delay your registration.

Complete your Mandatory Immunization Record online today to ensure your registration goes smoothly.