Get Immunization Verification Form For Holland College Healthcare 2020-2025

The Immunization Verification Form for Holland College Healthcare Programs is a crucial document for students entering health care fields. Properly completing this form ensures compliance with health regulations and facilitates participation in clinical settings.

Follow the steps to accurately complete the form.

1. Click ‘Get Form’ button to obtain the Immunization Verification Form and open it in your preferred editing application.
2. Begin by entering your full name in the 'Applicant Name' field. Ensure that the name matches the one on your official documents.
3. In the 'Phone No' field, provide a valid contact number where you can be reached.
4. Fill in your current address in the designated section to ensure correspondence can be accurately directed to you.
5. Review the guidelines regarding immunization requirements. Make sure you understand the importance of vaccinations and TB testing for health care workers.
6. Complete the section that requires confirmation of immunity for the vaccines listed. Each vaccine has an accompanying checkbox to indicate whether you meet the requirements.
7. For the Tuberculosis screening requirement, indicate whether you have undergone a two-step TST test within the last year.
8. The form must be signed by a physician or a public health official who will verify your immunization records. Ensure they fill in their contact information as required.
9. After completing all required sections, review the entire form to ensure accuracy and completeness.
10. Save your changes, then download or print the completed form to include it with your admissions application package.

Ensure your immunization records are ready and complete the Immunization Verification Form online.