E#: (Last) (First) Birthday / / Month Day (Middle Initial) Gender: Term Entering EIU: / Year Semester/Year Required Immunizations: Please provide the month, day and year of the most current vaccines. Immunization Mo Day Yr Mo Day Yr Mo Day Yr Mo Day Yr Mo Day Yr DTP, DtaP, DT, TD (Diphtheria and Tetanus)*** ***Students shall provide dates of any combination of three or more doses.
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How to fill out the Eastern Illinois University Immunization Form online
Completing the Eastern Illinois University Immunization Form is a vital step for students to ensure compliance with health requirements. This guide provides a comprehensive overview of each section and offers step-by-step instructions for users to fill out the form accurately and efficiently.
Follow the steps to effectively complete the immunization form.
- Click the ‘Get Form’ button to access the immunization form and open it in your preferred document editor.
- Begin by entering your name in the designated fields: last name, first name, and middle initial. Follow this by providing your student identification number (E#) and date of birth in the format of month/day/year.
- Select your gender and the term you are entering Eastern Illinois University, including the semester and year.
- In the 'Required Immunizations' section, accurately fill in the dates of your most current vaccines for each immunization listed. Ensure that you enter the month, day, and year for DTP, Tdap, MMR, and Meningococcal vaccines.
- In the 'Recommended Immunizations' section, similarly provide the dates for additional vaccines, including COVID-19, Hepatitis A, Hepatitis B, HPV, and Varicella. If applicable, include the date of the chickenpox disease.
- After you have filled in all necessary information, ensure that the records are signed and dated by a healthcare provider. Include their name, credentials, date, address, and telephone number.
- If you are under 18 and require treatment on campus, include a signature from your parent or legal guardian, along with their date of signature.
- Once you have completed all sections and ensured that your form is accurate, save your changes. You can then download, print, or share the form as needed.
Complete your immunization form online to ensure a smooth transition to Eastern Illinois University.
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Get answers to your most pressing questions about US Legal Forms API.
Do college students need to be vaccinated in Illinois?
Illinois state law requires certain immunizations for children and adults enrolled in child care, school, or college. State law also mandates immunizations for adults in specific fields of work (healthcare).
How do I submit my immunization records to ETSU?
You may either hand in your documentation in person, fax them to 423-439-4560, mail them to the University Health Center Box 70675, East Tennessee State University, Johnson City, TN 37614 or submit them directly to our Immunization Coordinator, Megan Flora, at immunizations@etsu.edu.
What immunizations are required for University of Illinois?
Why do I need to submit immunization forms? The Illinois College Immunization Code requires that college students enrolled on campus should be immunized against diphtheria, tetanus, pertussis, measles, mumps and rubella. Students under the age 22 must be immunized against meningitis.
How do I submit immunization records to IU?
Go to the Med+Proctor website or search for “Immunization Compliance” in One. IU to create an account and upload proof of compliance. Once you create a Med+Proctor account, you will have two options for submitting your documentation: Pay a one-time fee of $10 for lifetime access to any immunization records you upload.
Is the COVID vaccine mandatory in Illinois?
Health care workers, school personnel, higher education personnel, and higher education students must receive their first dose of a two-dose COVID-19 vaccine series or a single dose vaccine by September 19, 2021, and if applicable, receive the second dose in a two-dose vaccine series within 30 days (no later than ...
Does Eastern Illinois University require vaccine?
EIU expects every student who plans on taking any in-person classes on campus to have received a full COVID-19 vaccination. This expectation also extends to all EIU employees.
What are the requirements for Eastern Illinois University?
Admission: Beginning Freshmen Applicants for admission to EIU are considered, dependent upon facilities and resources, from candidates who have a minimum unweighted cumulative GPA of 2.5/4.0 scale and a minimum ACT score of 18/new SAT score of 960.
Does University of Illinois have a vaccine mandate?
The University of Illinois system will enter 2023 without COVID-19 vaccine mandates. The three-university system last week lifted its COVID-19 vaccine mandate for students and employees.
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