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University of Memphis Certificate of Immunization 2011 free printable template

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UNIVERSITY OF MEMPHIS CERTIFICATE OF IMMUNIZATION TENNESSEE STATE LAW requires all students entering the University of Memphis to provide documentation showing their immunizations are up-to-date. These requirements are mandatory under Tennessee State Law. Acceptable documents are The Certificate of Immunization form completed and signed by health care provider A copy of an official immunization card Shot record from your local Public Health Depar...
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How to fill out University of Memphis Certificate of Immunization

01
Obtain the University of Memphis Certificate of Immunization form from the university's website or admissions office.
02
Fill in your personal information including your full name, date of birth, and student ID.
03
List all required immunizations including dates received for each vaccine.
04
Ensure all entries are accurate and complete; missing information may delay processing.
05
Have a healthcare provider or clinic sign and stamp the form to verify the information.
06
Submit the completed Certificate of Immunization to the university's health services office by the deadline.

Who needs University of Memphis Certificate of Immunization?

01
All incoming students at the University of Memphis are required to submit the Certificate of Immunization.
02
Students enrolled in specific programs where health compliance is mandatory.
03
International students may also need to provide this certificate as part of their admission process.
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People Also Ask about

Full-time Tennessee college students Measles, Mumps, Rubella (2 doses of each, normally given together as MMR): if born on or after January 1, 1957 only. Varicella (2 doses or credible history of disease): if born on or after January 1, 1980 only.
All students registering as full-time students at the University of Memphis must provide proof of immunizations. Documentation of 2 MMR immunizations or proof of immunity for Measles, Mumps, and Rubella and documentation of 2 Varicella immunizations or proof of immunity for Varicella (Chicken Pox) are required.
Do I need any other vaccinations besides the MMR shots? MSU only requires documentation of two MMR (measles, mumps, and rubella) vaccinations and the Tuberculosis Screening Form. However, we recommend discussing your vaccination history and which shots you need to update with your primary care provider.
Children enrolling in Kindergarten Hepatitis B (HBV) Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate) Poliomyelitis (IPV or OPV) - final dose on or after the 4th birthday. Measles, Mumps, Rubella - 2 doses of each, usually given together as MMR. Varicella - 2 doses or credible history of disease.
The university strongly recommends that all students be fully vaccinated against COVID-19. The vaccines are safe, effective, and free.
varicella/chickenpox (VZV), and tetanus, diphtheria, pertussis (Tdap). In addition, meningococcal conjugate vaccine (MenACWY) is required for students aged 21 and younger. All Incoming Students must also complete an online screening questionnaire for tuberculosis (TB), based upon CDPH guidance.

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The University of Memphis Certificate of Immunization is a document that verifies a student's vaccination history and immunization status as required by the university for enrollment and attendance.
All new students, including undergraduate, graduate, and international students, are required to file the University of Memphis Certificate of Immunization to comply with state health regulations.
To fill out the University of Memphis Certificate of Immunization, students should complete the form with their personal information, list the required vaccinations received, and have the form signed by a healthcare provider.
The purpose of the University of Memphis Certificate of Immunization is to ensure that students are vaccinated against certain diseases to protect the health and safety of the campus community.
The Certificate of Immunization must report the student's name, date of birth, vaccination dates, types of vaccines received, and the signature of the healthcare provider verifying the information.
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