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Get the free Emory University Student Health Services Student Immunization Record - emory

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A record form for Emory University students to document their immunization history in compliance with CDC and American College Health Association guidelines.
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How to fill out Emory University Student Health Services Student Immunization Record

01
Obtain the Emory University Student Health Services Student Immunization Record form from the Emory Health Services website.
02
Fill in your personal information at the top of the form, including your name, student ID, and date of birth.
03
Review the immunization requirements listed on the form, which may include vaccinations for measles, mumps, rubella (MMR), hepatitis B, and others.
04
Gather documentation of your past vaccinations from your healthcare provider or medical records.
05
Enter the dates of your vaccinations in the appropriate sections of the form.
06
If you have not received certain vaccinations, indicate this on the form and discuss this with your healthcare provider for recommendations.
07
Sign and date the form to confirm the accuracy of the information provided.
08
Submit the completed form to Emory University Student Health Services by the designated deadline.

Who needs Emory University Student Health Services Student Immunization Record?

01
All incoming undergraduate and graduate students at Emory University are required to complete the Student Immunization Record.
02
International students may have additional immunization requirements based on their home country.
03
Students living on campus are particularly required to provide this record to ensure compliance with health regulations.
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Check with your high school and/or college health services for dates of any immunizations. Keep in mind that generally records are kept only for 1-2 years after students leave the system. Check with previous employers (including the military) that may have required immunizations.
Check with your high school and/or college health services for dates of any immunizations. Keep in mind that generally records are kept only for 1-2 years after students leave the system.
If your doctor has proof of your immunization history, this may be your preferred option. If you went to high school in the United States, it is very likely your records are on your high school transcript. If you already have these records, check and see if your immunization history is there!
Schools may keep records for a year or two after a student leaves or graduates. Contact your child's school for more information.
Emory University requires ALL students (including international students) to have health insurance that meets the university's mandatory insurance waiver criteria OR purchase a University-sponsored plan.
Graduated or former students will need to complete a Medical Records Release Form. After completing the form, then either mail, fax, or email/attach your request: The mailing address is: Emory University Student Health Services, ATTN: Medical Records, 1525 Clifton Rd, Atlanta, GA 30322. The eFax number is: 404-727-7343.

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The Emory University Student Health Services Student Immunization Record is a document that provides proof of a student's immunization history and compliance with the university's vaccination requirements.
All incoming students, including undergraduate, graduate, and professional students, are required to file the Emory University Student Health Services Student Immunization Record.
To fill out the Student Immunization Record, students should provide details of their vaccinations, including dates administered, types of vaccines, and the healthcare provider's information. It may need to be signed by a healthcare professional.
The purpose of the Student Immunization Record is to ensure that students meet necessary health requirements to protect themselves and the campus community from preventable diseases.
The information that must be reported includes the names of the vaccines received, dates of administration, and any relevant health history related to vaccinations.
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