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Get the free Evidence of Vaccination against Bacterial Meningitis - wtamu

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This form is used by incoming students at West Texas A&M University to provide evidence of their bacterial meningitis vaccination as per Texas House Bill 4189 requirements for living on-campus.
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How to fill out evidence of vaccination against

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How to fill out Evidence of Vaccination against Bacterial Meningitis

01
Obtain a vaccination record from your healthcare provider or vaccination clinic.
02
Ensure the record includes the date of vaccination, the type of vaccine administered, and the provider's information.
03
Fill out any required personal information, such as your name, date of birth, and contact information, on the form provided by the institution requesting the evidence.
04
If submitting electronically, scan or take a clear photo of the vaccination record to ensure legibility.
05
Submit the completed form along with the vaccination record to the appropriate office or platform as instructed.

Who needs Evidence of Vaccination against Bacterial Meningitis?

01
College or university students, especially those living in dormitories.
02
Individuals in certain educational programs, such as nursing or healthcare.
03
Travelers to specific regions where bacterial meningitis is prevalent.
04
Participants in certain activities or events that require communal living or high interaction.
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A form with the signature or stamp of a physician, designee, or public health personnel with the agency name and address; which documents when (month, date, four-digit year) the vaccination or booster was administered. An official immunization record generated from a state or local health authority.
College students living in dorms and military members in barracks are at higher risk,” Messina explains. “Sharing cigarettes or drinks, kissing or other intimate contact also increase risk.” The symptoms of meningitis B can mimic the flu with non-specific complaints such as nausea, muscle pain and fever.
If you aren't sure whether your teen or young adult has received meningitis B vaccination, contact their healthcare provider's office and ask for your child's vaccination records. If records confirm they haven't received meningitis B vaccination yet, bring it up at the next doctor visit.
College students living in dorms and military members in barracks are at higher risk,” Messina explains. “Sharing cigarettes or drinks, kissing or other intimate contact also increase risk.” The symptoms of meningitis B can mimic the flu with non-specific complaints such as nausea, muscle pain and fever.
A document bearing the signature or stamp of the physician, a designee, or the public health personnel who administered the immunization. An official immunization record generated by a state or local health authority. An official immunization record from another school, including those from another state.

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Evidence of Vaccination against Bacterial Meningitis is an official record that shows an individual has received the meningococcal vaccine, which protects against certain strains of bacterial meningitis.
Typically, incoming college students, especially those living in dormitories, and certain high school students are required to file Evidence of Vaccination against Bacterial Meningitis.
To fill out the Evidence of Vaccination, individuals need to provide personal information such as name and date of birth, details of the vaccination including the date it was administered, the type of vaccine, and the healthcare provider's signature or stamp.
The purpose of Evidence of Vaccination against Bacterial Meningitis is to ensure that individuals are vaccinated to protect against the health risks associated with bacterial meningitis, particularly in enclosed living environments.
The information that must be reported includes the individual's full name, date of birth, vaccination dates, type of vaccine received, the administering provider's information, and any necessary signatures.
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