Get Eastern Illinois University Immunization Form 2021-2025

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.

1. Click the ‘Get Form’ button to access the immunization form and open it in your preferred document editor.
2. 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.
3. Select your gender and the term you are entering Eastern Illinois University, including the semester and year.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.