Get Immunization Certificate - Mount Ellis Academy - Mtellis

Filling out the immunization certificate is a vital step for students attending Mount Ellis Academy. This guide provides a clear approach to assist you in accurately completing the form online, ensuring all required immunization information is properly documented.

Follow the steps to fill out the immunization certificate with ease.

1. Press the ‘Get Form’ button to acquire the immunization certificate and open it for editing.
2. Enter the student's name in the designated field at the top of the form.
3. Locate the section for Diphtheria/Tetanus/Pertussis immunizations. Input the three dates of prior vaccinations, followed by the date of the latest booster received within the last ten years.
4. Proceed to the Polio section. Choose either the four-date option or three-date option with the required booster, and fill in the respective date fields.
5. For Measles, provide two dates of vaccination in the specified areas.
6. In the Rubella section, fill out either two dates of vaccination or the date of a positive blood titer test that confirms immunity.
7. Input two dates for Mumps vaccination as needed.
8. Complete the Hepatitis A & B section by entering the three vaccination dates.
9. Indicate whether the student has or has not been immunized against Tuberculosis. If immunized, skip to the next section. If not, include the TB Skin Test date and results.
10. As the medical doctor completing this form, provide your name, practice details, telephone number, signature, and the date.
11. Lastly, the student's guardian(s) must sign and date the authorization for medical treatment and consent section.
12. Once all sections have been completed, save your changes. You can then download, print, or share the immunization certificate as needed.

Complete your immunization certificate online today to ensure a smooth enrollment process.