Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to acquire the form and access it in your preferred editor.
2. Fill in your personal information at the top of the form, including your last name, first name, date of birth, street address, medical school, city, state, ZIP code, cell phone number, primary email, student ID, and the last four digits of your social security number.
3. Proceed to the MMR section. Indicate your vaccination status by selecting either the vaccine option or providing serologic proof of immunity for measles, mumps, and rubella. For each vaccine dose, enter the corresponding dates.
4. In the Hepatitis B section, document your vaccination status. Include the dates for the primary series and if necessary, the secondary series, following it with the quantitative Hepatitis B Surface Antibody result.
5. Complete the Tetanus-diphtheria-pertussis section by listing the date of your most recent Tdap dosage. If your last Tdap was over ten years ago, include the date of your last Td vaccination.
6. Fill out the Tuberculosis screening section by indicating the results of your last tests. Use one section to document either skin tests or blood tests, including all necessary dates and readings.
7. Continue to the Varicella section, detailing the dates for the two doses of vaccine or the result of your serologic immunity test.
8. Complete any other required sections for additional vaccinations, such as the influenza vaccine or meningitis vaccine, indicating the corresponding dates.
9. At the bottom of the form, ensure that a healthcare provider or institutional representative fills in their authorization details, including the signature, date, and printed name.
10. Once all fields are completed, review the form for accuracy. Save changes, then download, print, or share the form as required.

Take the next step in your medical education by completing the Aamc Immunization Form 2021 online today.