Get Student Immunization Record - Manipal.edu

Completing the Student Immunization Record is a critical step for students to ensure compliance with registration requirements at the university. This guide provides clear instructions on filling out the form accurately and efficiently.

Follow the steps to complete your student immunization record.

1. Click ‘Get Form’ button to access the form and open it for completion.
2. Begin by entering your personal information. Fill in your name, date of birth, roll number, phone number, and the name of the institution.
3. In the immunization history section, provide the required vaccination dates for Hepatitis B. You may also need to include the Hepatitis B antibody titer results.
4. Next, record the details for the Varicella (Chicken Pox) immunizations. You can list the dates of immunizations or note if you had the disease or the titer status.
5. Complete the section for Mumps, Measles (Rubeola), and Rubella by providing the vaccination dates or titer results as applicable.
6. Fill out your medical history. Provide information about any allergies, current medications, and existing medical conditions.
7. Ensure that a registered medical practitioner signs the form or attach a valid certificate from the Health Department. This signature is crucial for the form's acceptance.
8. Review the declaration section carefully. Sign and date the declaration, affirming the accuracy of the information provided.
9. Complete the process by saving the form, downloading it for your records, printing a copy if needed, or sharing it as required.

Complete your Student Immunization Record online today to ensure a smooth registration process.