AST NAME (PLEASE PRINT) FIRST NAME MIDDLE NAME STONY BROOK ID# HOME ADDRESS STREET/APT.# CITY/TOWN STATE/PROVINCE CELL PHONE HOME PHONE EMERGENCY CONTACT RELATIONSHIP ZIP CODE COUNTRY (IF NOT U.S.) E-MAIL CELL PHONE New York State Public Health Law and Stony Brook University Policy require that all students must verify by their signature that they have received information about meningococcal disease and have made an informed decision about whether or not to receive immunization a.
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How to fill out the Stony Brook University Meningitis Response Form online
The Stony Brook University Meningitis Response Form is a crucial document for students to certify their understanding of meningococcal disease and their vaccination status. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to complete the form successfully.
- Press the ‘Get Form’ button to access the Meningitis Response Form online and open it in your document editor.
- Begin by entering your last name in the designated field. Ensure it is clear and legible.
- Continue with your first name and middle name as instructed. This information is required for identification purposes.
- Input your Stony Brook ID number in the appropriate section. This is essential for your registration process.
- Fill in your home address, including street and apartment number. Ensure to provide accurate city, state, and zip code information.
- Provide your cell phone number and home phone number for emergency contact purposes.
- List an emergency contact person's name along with their relationship to you.
- If you are not residing in the United States, please specify your country of residence.
- Enter your email address and repeat your cell phone number for communication purposes.
- Review the instructions concerning the New York State public health law and Stony Brook University policy. Ensure you understand the requirements.
- Select one of the checkboxes to indicate whether you have had the meningococcal meningitis immunization within the past 5 years or if you have read the information and chosen not to get vaccinated.
- Sign the form. If you are under the age of 18, a parent or guardian must sign on your behalf.
- Indicate the relationship of the signer if it is a parent or guardian. Then, include the date of signing.
- Before submitting, make a copy of the completed form for your records.
- Finally, upload the completed form to the Patient Portal as directed.
Complete your Meningitis Response Form online today to ensure your compliance and avoid any registration issues.
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How do I submit meningitis form on Cunyfirst?
Log into your CUNY First account • Select the Student Center icon • Select the Tasks and Holds icon • Click the Meningitis Acknowledgment button • Read, make your selection, and submit. provide meningitis vaccination proof. When uploading use a desktop or laptop computer, not a mobile device.
Why do you have to get a meningitis shot for college?
For example, risk for meningococcal disease in college students is slightly higher than the risk for teens and young adults not attending college. Policies around vaccine requirements to prevent college disease outbreaks are often determined by state legislatures.
What is the meningitis response form?
Provide information about a student's past immunization for meningitis, or confirm that the student will not be immunized.
What percent of college students get meningitis?
Table 2. YearIncidence among college studentsIncidence among non-college students 2015 0.21 0.11 2016 0.29 0.15 2017 0.34 0.11 2018 0.16 0.08 Oct 6, 2021
How do you get meningitis university?
The bacteria that can cause bacterial meningitis are spread by direct secretions (saliva or spit) from the nose and mouth, through activities such as kissing, sharing food, drinks, water bottles, toothbrushes, eating utensils, cigarettes and other smoking products/devices.
What meningitis do you need for college?
Meningococcal Serogroup B (MenB) ing to the Centers for Disease Control and Prevention (CDC), MenACWY is the vaccine recommended for this age group of college students. However, both vaccines, MenACWY and MPSV4, protect against the same four strains of bacterial meningitis (A, C, W, and Y).
What is meningitis for college?
The MenACWY vaccine is recommended for college freshman living in a dormitory. The vaccine has been recommended for 11-12 year olds since 2005, so it is possible that incoming freshmen have already received a dose. If you received a dose before age 16, you should get a booster before you go to college.
What causes meningitis in college students?
The close contact in college residence halls, combined with certain behaviors (such as alcohol consumption, exposure to cigarette smoke, sharing food or beverages, and other activities involving the exchange of saliva), may put college students at increased risk. Is there a vaccine against meningococcal disease?
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