Get Keuka College Health Form/immunization Record

Filling out the Keuka College Health Form/Immunization Record online is a crucial step for students to ensure their compliance with health requirements before attending classes. This guide will provide you with step-by-step instructions to complete the form accurately and efficiently.

Follow the steps to complete your health form online effectively.

1. Click ‘Get Form’ button to obtain the health form and access it in your preferred editor.
2. Begin by filling out your personal information in the designated fields, including your last name, first name, middle name, address, and contact numbers.
3. Provide your date of birth and indicate your sex by selecting the appropriate option.
4. Answer whether you have previously attended Keuka College and, if applicable, the year you stopped attending.
5. If your name has changed, record the name under which you were previously enrolled.
6. Next, complete the emergency contact section by providing the name, address, phone numbers, and relationship of your emergency contact.
7. The immunization record section needs to be filled out. Ensure your health care provider documents proof of immunity to measles, mumps, and rubella as required. If needed, indicate if you are exempt from certain vaccinations.
8. Obtain the signature of your health care provider and ensure they fill in their printed name, contact information, and address.
9. Affix your signature and date the form to confirm the information provided.
10. Once you have completed the form, save your changes. You have the option to download, print, or share the form as required.

Complete your health forms online today to ensure a smooth enrollment process!