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CALIFORNIA STATE UNIVERSITY SAN BERNARDINO The Opportunity for the Future STUDENT HEALTH CENTER IMMUNIZATION EXEMPTION DECLARATION Student Name /ID.# (Please print) *Students understand and acknowledge.

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Face Coverings on Campus All conference attendees, regardless of vaccination status, are required to wear face coverings while indoors on campus.

The CSU replaced its policy requiring that students be vaccinated for Measles, Mumps, Rubella, Chickenpox, TDAP (Tetanus, Diphtheria, Pertussis), Tuberculosis, and Hepatitis B. The new policy eliminates all vaccination requirements except the one for Hepatitis B and is effective February 14, 2023.

Contact Us Currently enrolled students can upload your medical records via the Patient Portal. Use this address to send them by mail: Attn: Student Health Center, CSUSB. 5500 University Parkway,

Please complete this form and return it to Queens College, Health Service Center, 6530 Kissena Blvd, Frese Hall 3rd Floor, Queens, N.Y. 11367 or email: healthquestions@qc.cuny.edu, or fax: 718-997-2765. Document must be legible to be processed.

To clear a hold, please call (909) 537-5241, and send your immunization records to the Student Health Center. Please be sure to include your Coyote Identification Number (Coyote ID) with your records. Medical records can only be accepted by mail or through the Coyote Health Portal at this time.

Students may purchase quarter or annual coverage based on their individual needs. Students on a government scholarships which provide insurance coverage, must show proof to our office in CE-356 in order to be excluded. Steps to enroll in coverage: Visit USI.

The office of Systemwide Human Resources/Labor Relations informed CFA that, “As the nation and our local communities transition out of a state of emergency due to COVID-19, the CSU has made the decision to no longer require students to be fully vaccinated against the COVID-19 virus.

Visit your single sign-on webpage: https://sso.csulb.edu and complete the Vaccine Certification web form.

Prior to arriving on any University property or participating in any University-related activity, members of the University community and visitors must conduct a personal health screening and self-monitor for COVID-19 related symptoms by completing a daily health screen prior to arriving on the campus.

Additional information is also available on the following websites: TO SUBMIT IMMUNIZATION RECORDS: Mail to: College of Staten Island, Health & Wellness Services, 2800 Victory Blvd., Staten Island, NY 10314. Fax to: 718.982.2966. Email: HealthCenter@csi.cuny.edu.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232