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Se print in black ink) FOR INDIVIDUAL SCHOOLS TO EDIT To be completed by student REPORT OF MEDICAL HISTORY LAST NAME (print) FIRST NAME MIDDLE/MAIDEN NAME PERMANENT ADDRESS CITY DATE OF BIRTH (mo/day/yr) GENDER CLASS YOU ARE ENTERING (circle): FR. SO. JR. SR. GRAD. PROF. PERSONAL ID#(PID) STATE M F ZIP CODE MARITAL STATUS PREVIOUSLY ENROLLED HERE IF YES, DATES YES NO PREVIOUSLY A PATIENT HERE IF YES, DATES YES NO *SOCIAL SECURITY NUMBER S AREA CODE/PHONE NUMBER M OTHER E.

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North Carolina Vaccine-Specific Requirements. The North Carolina General Statutes (G.S. 130A-152(a)) require immunizations for every child present in this state. ... Diphtheria, tetanus and pertussis. Polio. Measles. Mumps. Rubella. Haemophilus influenzae type b (Hib) Hepatitis B.

North Carolina law requires all children in the state to receive certain immunizations. Records are checked when children enter school or child care.

Immunization Requirements COLLEGE/UNIVERSITY VACCINES AND NUMBER OF DOSES REQUIREDVaccines RequiredTetanus, Diphtheria, Acellular Pertussis (Tdap)1Measles3Doses Required12

Colleges and Universities Diphtheria, tetanus and pertussis. Three doses are required for individuals entering college or university. ... Polio. Three doses are required for individuals entering college or university. ... Measles. ... Mumps. ... Rubella. ... Hepatitis B. ... Varicella.

7th-grade students will need to get a Tdap vaccine as well as the Meningococcal conjugate vaccine (MCV).

If a student does not provide proof of immunization, North Carolina public law requires NC State University to drop them from all classes. The re-enrollment fee is $150.

North Carolina law requires all children in the state to receive certain immunizations. Records are checked when children enter school or child care. Information in this section is categorized ing to school or grade level.

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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
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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:
+1 833 426 79 33
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