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This form provides information about meningococcal meningitis risks for college students and includes a waiver for those who decline the vaccination.
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How to fill out meningitis info sheet and
How to fill out Meningitis Info Sheet and Waiver Form
01
Obtain the Meningitis Info Sheet and Waiver Form from your healthcare provider or school.
02
Carefully read the Meningitis Info Sheet to understand the disease and vaccination details.
03
Fill out personal information such as your name, date of birth, and contact information on the form.
04
Indicate your vaccination status by selecting the appropriate checkbox or writing in the date of your vaccination.
05
If choosing to waive the vaccination, provide a signature and date in the indicated section.
06
Review the completed form for accuracy and completeness.
07
Submit the form to the designated office at your school or healthcare provider.
Who needs Meningitis Info Sheet and Waiver Form?
01
All incoming college students.
02
Students residing in on-campus housing.
03
Individuals who have not previously received the meningitis vaccine.
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How to get meningitis vaccine waiver?
Exemptions: Students may begin classes without a certificate of immunization against meningococcal disease if: 1) the student has a letter from a physician stating that there is a medical reason why he/she can't receive the vaccine; 2) the student (or the student's parent or legal guardian, if the student is a minor)
Why do colleges ask for meningitis vaccine?
Anyone can get meningococcal disease, but first-year college students who live in dormitories or participate in sororities or fraternities are at increased risk and should get vaccinated.
What is exemption for meningitis vaccine?
Students in public institutions of higher education who reside in on-campus housing must have received the meningococcal vaccine. Exemptions are permitted with proof of immunity or objection in writing due to religious beliefs. Students in postsecondary schools must be immunized against rubella and measles.
What is a meningitis response form?
Provide information about a student's past immunization for meningitis, or confirm that the student will not be immunized. If student is a minor, you can also use this form to provide consent for general medical treatment by Student Health Services.
What is a meningitis waiver?
The law provides an exemption for students signing a waiver that reviews the dangers of meningococcal disease and indicates that the vaccination has been declined. To qualify for this exemption, you are required to review the information below and sign the waiver at the end of this document.
What does it mean to waive receipt of meningococcal vaccine?
Individuals 18 years of age and older may sign a written waiver choosing not to be vaccinated against meningococcal disease after reviewing the information on the risks of meningococcal disease, the availability of the vaccine, and effectiveness of the vaccine.
What does it mean to waive receipt of meningococcal vaccine?
Individuals 18 years of age and older may sign a written waiver choosing not to be vaccinated against meningococcal disease after reviewing the information on the risks of meningococcal disease, the availability of the vaccine, and effectiveness of the vaccine.
What is the general information about meningitis?
Overview. Meningitis is the inflammation of the tissues surrounding the brain and spinal cord. It can be infectious or non-infectious in origin, can be associated with high risk of death and long-term complications, and requires urgent medical care.
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What is Meningitis Info Sheet and Waiver Form?
The Meningitis Info Sheet and Waiver Form is a document that provides information about meningitis and allows individuals to acknowledge that they have received this information and make a decision regarding vaccination.
Who is required to file Meningitis Info Sheet and Waiver Form?
Typically, incoming college students, particularly those living in residence halls, are required to file the Meningitis Info Sheet and Waiver Form.
How to fill out Meningitis Info Sheet and Waiver Form?
To fill out the form, individuals must provide their personal information, review the meningitis information provided, and indicate whether they have been vaccinated or wish to waive the vaccination.
What is the purpose of Meningitis Info Sheet and Waiver Form?
The purpose of the form is to educate individuals about the risks associated with meningitis and to document their vaccination status or their decision to waive vaccination.
What information must be reported on Meningitis Info Sheet and Waiver Form?
The form typically requires personal details such as name and contact information, vaccination status, and a signature to confirm understanding of the provided information.
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