Get University Of Texas At Dallas Meningococcal Meningitis Vaccine Requirement Form 2013-2025
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How to fill out the University of Texas at Dallas Meningococcal Meningitis Vaccine Requirement Form online
Completing the University of Texas at Dallas Meningococcal Meningitis Vaccine Requirement Form online is an essential step for students planning to enroll. This guide will provide you with clear, step-by-step instructions for filling out the form accurately and efficiently.
Follow the steps to complete the form successfully.
- Click ‘Get Form’ button to access the Meningococcal Meningitis Vaccine Requirement Form and open it in your chosen environment.
- In Section A, enter your UTD ID number and complete your name (first, middle, last). Indicate your student status by selecting one of the options: U.S. Citizen, Permanent Resident, or International.
- Provide your birth date in the specified format (MM/DD/YYYY) and complete your contact details including your phone number and email address.
- If you are under the age of 18, complete the parental/representative permit section by printing your parent or guardian's name, relationship, and obtaining their signature and date.
- In Section B, indicate that you understand the vaccination information provided. Sign to confirm and include the date of vaccination (MM/DD/YYYY). You must check one of the boxes regarding included documentation: a statement from a physician, your official immunization record, or a record from an educational institution.
- In Section C, sign to confirm your understanding of the vaccine information. If opting out of vaccination, indicate your reason and ensure that appropriate documentation is attached.
- After all sections are completed, review the form for accuracy. Once satisfied, save the changes, and consider downloading, printing, or sharing the form as necessary.
Complete your form online today to ensure your registration process is smooth and compliant.
All new students, including transfer students, must show evidence of receipt of an initial bacterial meningitis vaccination (meningococcal meningitis vaccine) dose or booster in the last five years and at least ten days prior to the first day of the semester session in which the student initially enrolls.
Fill University Of Texas At Dallas Meningococcal Meningitis Vaccine Requirement Form
The statement must include the name, address, signature or stamp, state of licensure and license number of the physician or other healthcare. Listed below are the acceptable forms of evidence a student may use to submit to the institution. Students must provide evidence that the vaccination was administered at least 10 days prior to the first day of classes and within the last 5 years. A separate, signed application must be submitted for each individual to receive an exemption from Texas meningococcal vaccination requirements. You must show evidence of a bacterial meningitis vaccination (meningococcal meningitis vaccine) dose or booster. Undergraduates must request a Texas State Exemption Form online. The vaccine must be administered within the past five years and at least 10 days before the first day of classes. Texas law (SB 1107) mandates that all entering UT students who will be 21 or younger on the first day of classes must receive the bacterial meningitis vaccine. Meningitis Vaccine Requirements. Information about UNT's meningitis vaccine requirement for students can be found on the Registrar's website.
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