Get Complete And Mail Or Fax To: Immunization Program Fax: (940) 898-3849 Immunization Record For
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How to use or fill out the Complete and Mail or Fax to: Immunization Program Fax: (940) 898-3849 Immunization Record For online
This guide provides clear instructions on how to complete the Immunization Record required for nursing majors at Texas Woman's University. Follow the steps carefully to ensure accurate completion and compliance with university policies.
Follow the steps to fill out your immunization record correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Start by filling in your name as it appears on your identification documents. Ensure that all names are spelled correctly.
- Provide your Social Security Number to help identify your records accurately.
- Enter your date of birth in the specified format (MM/DD/YYYY) to confirm your eligibility and identity.
- Fill in your email address and phone number. This information may be used for communication regarding your immunization records.
- Complete your current address, including city, state, and zip code, where you can be contacted.
- Indicate your sex by selecting male or female as required by the form.
- Provide proof of immunizations as specified. List the dates of your MMR doses and ensure you have proper documentation attached.
- Enter details about your Tetanus/Diphtheria/Pertusis booster dose and TB screening. Make sure to choose the appropriate test option and include lab reports where necessary.
- Specify details for the Hepatitis B and Varicella vaccines, including dates and titer results. Attach lab reports as needed.
- Have a healthcare provider sign the form and ensure their contact information is accurate. This verification is crucial for compliance.
- Read and sign the certification statement to complete your record. Ensure that all information is accurate and complete before submission.
- Once you have filled out the form, save changes, download, print, or share it as necessary to submit to the Immunization Program.
Complete your immunization record online today to ensure timely compliance with Texas Woman's University requirements.
Where do I upload photos of my immunization records? All photos or files can be submitted on The Ashe Center Patient Portal by clicking Medical Clearances, then selecting Immunization Upload, then Update. Document Submission FAQs - UCLA Immunization Requirements UCLA Immunization Requirements https://immunizationrequirement.ucla.edu › document-su... UCLA Immunization Requirements https://immunizationrequirement.ucla.edu › document-su...
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