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Northwestern State University of Louisiana Proof of Immunization Compliance 2008 free printable template

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NORTHWESTERN STATE UNIVERSITY OF LOUISIANA PROOF OF IMMUNIZATION COMPLIANCE (Louisiana R.S. 17:170.1 Schools of Higher Learning) SS Number: Date of Birth: Month Date Year Name: Please Print (Last)
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How to fill out Northwestern State University of Louisiana Proof of Immunization Compliance

01
Obtain the Northwestern State University of Louisiana Proof of Immunization Compliance form from the university's website or student services.
02
Fill in your personal information, including your name, student ID, and contact details.
03
Provide accurate dates for all required immunizations, including measles, mumps, rubella, and any other vaccinations specified by the university.
04
If applicable, include any exemptions and provide supporting documentation as required.
05
Have a healthcare provider sign and date the form to verify your immunization history.
06
Submit the completed form to the designated office at Northwestern State University, either online or in person, by the specified deadline.

Who needs Northwestern State University of Louisiana Proof of Immunization Compliance?

01
All incoming students, including undergraduates and graduates, at Northwestern State University of Louisiana must submit the Proof of Immunization Compliance.
02
Students enrolling in specific programs, particularly those involving clinical or fieldwork, may have additional requirements.
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Northwestern State University of Louisiana Proof of Immunization Compliance is a document that verifies a student's vaccination status and compliance with state-mandated immunization requirements.
All new students, including incoming freshmen and transfer students, are required to file the Proof of Immunization Compliance.
To fill out the Proof of Immunization Compliance, students must complete the provided form with their immunization history, including dates of vaccinations and any exemptions, and submit it to the university's health services.
The purpose of the Proof of Immunization Compliance is to ensure that students are protected against certain vaccine-preventable diseases and to comply with state health regulations.
The information that must be reported includes the student's name, date of birth, vaccination dates, the type of vaccines received, and any exemptions or declinations.
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