Get University Of Memphis Certificate Of Immunization Form

Completing the University Of Memphis Certificate Of Immunization Form online is essential for students enrolling as full-time participants. This guide provides a detailed walkthrough of each section of the form, ensuring you understand the requirements for submitting your immunization records confidently.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to access the Certificate Of Immunization Form and open it for editing.
2. Fill in your personal information at the top of the form. This includes entering your last name, first name, middle initial, birth date, student ID number, phone number, and current mailing address.
3. Indicate the semester you are entering by selecting one of the options: Fall, Spring, or Summer, and provide the year.
4. Complete the MMR Immunization section if applicable. If you were born before 1957, or are a part-time student, or graduated from a Tennessee high school in 1999 or later, you may not need to fill this out. Otherwise, include dates for your two MMR immunizations or applicable exemption requests.
5. Complete the Varicella Immunization section if applicable. If you were born before January 1, 1980, or are a part-time student, you may not need to fill this out. Otherwise, provide the dates for your two Varicella immunizations or applicable exemption requests.
6. Have your healthcare provider complete the certification section. This requires the provider's printed name, address, signature, and phone number.
7. Review all the filled sections to ensure accuracy. Missing personal information may delay processing.
8. Once completed, save your changes. You can then download, print, or share the form as needed.

Take action now and complete your Certificate Of Immunization Form online for a smooth registration process.