Get University Of Mississippi Certificate Of Compliance

Filling out the University of Mississippi Certificate of Compliance is essential for students born after January 1, 1957, to ensure they meet vaccination requirements. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete your Certificate of Compliance online.

1. Click ‘Get Form’ button to access the University of Mississippi Certificate of Compliance and open it in your preferred online editor.
2. Enter your name in the designated field. Ensure all spelling is correct and legible.
3. Provide your Social Security Number in the specified section. Double-check for accuracy before proceeding.
4. Indicate your date of birth by selecting the appropriate month, day, and year from the drop-down menus.
5. Record the date of your first MMR vaccination by selecting the month and day, followed by the year.
6. Input the date for your second MMR vaccination in the same format as the first.
7. If applicable, document the dates for individual vaccinations (Rubeola, Rubella, Mumps) in the respective fields provided.
8. If you are providing proof of immunity through serologic testing, check the appropriate boxes and ensure to attach copies of lab results.
9. If you have personally had any of the diseases, check the corresponding boxes and attach any necessary office records.
10. If you or your health care provider indicates a medical contraindication for vaccinations, please provide detailed reasons in the space provided.
11. Optionally, fill in the recommended but not mandatory immunization dates, including Td/Tdap, Polio, Varicella, and the Hepatitis B series.
12. Ensure the form is signed by your health care provider in the designated signature area and include their address and telephone number.
13. Affix the office stamp of the health care provider on the form.
14. After completing the form, save your changes. You can download, print, or share the document as required.

Complete your University of Mississippi Certificate of Compliance online today to ensure a smooth registration process.