Fort Valley State University Certificate of Immunization 2010 free printable template
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CERTIFICATE OF IMMUNIZATION Part I- To be completed by the student Name Last Name First Name Address Street Date of Birth / / City M State F Zip SSN/Student ID# / / Part II- To be completed and signed
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How to fill out Fort Valley State University Certificate of Immunization
01
Obtain the Fort Valley State University Certificate of Immunization form from the university's website or student health office.
02
Fill out the student's personal information, including name, date of birth, and student ID number.
03
List the immunizations the student has received, including dates for each vaccination.
04
Ensure that all required immunizations (such as MMR, DTaP, and others) are documented according to university requirements.
05
If necessary, attach any official vaccination records or documentation from healthcare providers.
06
Sign and date the certificate to verify the information is accurate.
07
Submit the completed certificate to the appropriate office at Fort Valley State University before the deadline.
Who needs Fort Valley State University Certificate of Immunization?
01
All incoming students at Fort Valley State University are required to submit a Certificate of Immunization.
02
Students enrolling in certain programs may also need to provide this certificate to meet health and safety regulations.
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What is Fort Valley State University Certificate of Immunization?
The Fort Valley State University Certificate of Immunization is a document that verifies a student's immunization history and compliance with state health regulations.
Who is required to file Fort Valley State University Certificate of Immunization?
All students enrolling at Fort Valley State University, particularly those residing in on-campus housing, are required to file the Certificate of Immunization.
How to fill out Fort Valley State University Certificate of Immunization?
To fill out the Fort Valley State University Certificate of Immunization, students must provide their personal details, vaccination history, and signatures from their healthcare provider or parent/guardian if under age.
What is the purpose of Fort Valley State University Certificate of Immunization?
The purpose of the Certificate of Immunization is to ensure that all students are up to date with required vaccinations, thereby protecting their health and the health of the campus community.
What information must be reported on Fort Valley State University Certificate of Immunization?
The information that must be reported includes the student's name, date of birth, vaccination dates, types of vaccines received, and the attending healthcare provider's information.
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