Get Immunization Record - Medgar Evers College

Completing the Immunization Record for Medgar Evers College is essential for your registration process. This guide provides step-by-step instructions to ensure that you fill out the form accurately and effectively.

Follow the steps to successfully complete your immunization record.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin with Part 1: Student Information. Fill out your name, date of birth, EMPL ID number, daytime phone number, and email address. Ensure that all information is accurate and legible.
3. Proceed to Part 2: Immunization History. This section must be completed by a health care provider. Provide the details of the vaccinations you have received, including dates and proof of immunity based on New York State Public Health Law requirements.
4. In Part 3: Meningococcal Meningitis, check one box to indicate your vaccination status. Sign and date the section, ensuring that you understand the implications of your choice for immunization.
5. Verify that all required documents, such as immunization records or proof of immunization, are attached. Make sure the health care provider has included their information and official stamp.
6. Once you have filled out the form completely, save your changes, and download or print the document for your records. You can then submit your immunization record via mail, fax, or email to the Office of Health Services.

Complete your Immunization Record online today to ensure timely registration at Medgar Evers College.