Get Student Immunization Form - New York Institute Of Technology

Filling out the Student Immunization Form for the New York Institute of Technology is an essential step in ensuring your compliance with health regulations. This guide will provide clear instructions for completing the form online, allowing you to submit your immunization records smoothly.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the document and open it in the editor.
2. Begin with Part I, where you will enter your personal information. Provide your last name, first name, date of birth, NYIT ID, semester attending, email, and campus location (select from Old Westbury, Manhattan, or Central Islip).
3. In Part II, address the meningococcal meningitis response. Indicate the date you received the meningitis vaccine, if applicable. Read the information on meningococcal meningitis disease, then state whether you plan to obtain the vaccine or not. If you are under 18, ensure that a parent or guardian signs the section on your behalf.
4. Proceed to Part III where you will provide proof of measles, mumps, and rubella immunity. For each section, note the dates of your vaccinations or provide dates and results of any blood titer tests you have had. If you are providing proof via a blood titer, ensure to include a copy of the lab report.
5. Complete the health care provider information section. Insert the name and license number of your health care provider, along with their signature, date, and telephone number.
6. Before submission, ensure that all required sections are fully completed and review the information for accuracy. Once verified, you can save your changes, download a copy for your records, print the document, or share it as needed.

Complete your Student Immunization Form online today to ensure a smooth enrollment process!