Get Immunization Record Form. Immunization Record Form
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How to fill out the Immunization Record Form online
Completing the Immunization Record Form is essential for students prior to registration at The City University of New York. This guide provides a clear, step-by-step outline to help users easily fill out and submit the form online.
Follow the steps to effectively fill out the Immunization Record Form
- Click the ‘Get Form’ button to access the Immunization Record Form and open it in your preferred editor.
- Begin by filling out Part 1: Student Information. Clearly print your last name, first name, and employee ID number (Empl ID #), which is an 8-digit number found in your CUNYfirst account. Also include your date of birth, middle initial, daytime telephone number, and email address.
- In Part 2: Immunization History, provide details regarding your immunization. Consult with your healthcare provider to complete this section accurately. Ensure that all dates include the month, day, and year. Check off the appropriate boxes for the vaccines received and attach the necessary documentation as outlined.
- For Part 3: Meningococcal Meningitis, carefully read the instructions and check only one box in Section A that applies to you or your child. In Section B, sign and date to confirm your understanding and choice regarding meningococcal immunization. If you are under 18, a parent or guardian must sign.
- Once all sections are accurately completed, review the form for any illegibility. Submit the completed Immunization Record Form along with required documentation exclusively online through the CUNYfirst Document Uploader.
- Consider saving a copy of the form for your records after submission, and note that you may also download, print, or share the form if needed.
Complete your Immunization Record Form online for a smooth registration process.
You may also request an immunization record by mail/fax using this form or by visiting .mcir.org/public/. All requests require a photocopy of the requestor's current state issued driver's license or picture I.D. The requester must state relationship to the child or dependent for persons under 18 years of age. How do I request a copy of my child or dependent's State of Michigan ... mcir.org https://mcir.org › wp-content › uploads › 2021/05 › Req... mcir.org https://mcir.org › wp-content › uploads › 2021/05 › Req...
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