Get 1form A Immunization Verification Form Rev 2015-2016docx - Rivier

Filling out the 1FORM A Immunization Verification Form is an essential step for all resident and half-time commuter students at Rivier University. This comprehensive guide will help you navigate the form with clarity and confidence.

Follow the steps to accurately complete the immunization verification form.

1. Click ‘Get Form’ button to obtain the form and open it in your browser.
2. Indicate your status by checking one of the options: resident or commuter student. It is important to select the correct status to ensure your submission is processed accurately.
3. Fill in your personal details, including your name, date of birth, and last four digits of your Social Security number. Make sure to double-check these entries for accuracy.
4. Provide your home address by including your street number, city, state, and zip code to complete the contact information section.
5. In the REQUIRED VACCINES section, you will list the required immunizations. Enter the dates corresponding to your MMR, Tdap, and meningitis vaccines. Ensure that the dates are accompanied by the necessary documentation or proof.
6. If applicable, complete the RECOMMENDED vaccines section by entering the dates for Hepatitis B and vaccines, if they have been administered.
7. Verify the accuracy of the immunization dates and provide your health care provider's name, signature, and contact information in the designated areas.
8. Finally, make sure to submit the completed form by August 15. Options for submission include mailing it to Quibin Student Health Services or sending it via fax.

Ready to fill out your documents online? Start by accessing the immunization verification form.