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IMMUNIZATION FORM Date of Immunization 1. Measles 2 doses since 01/01/68 or positive Tier; Exempt if born on or before 01/01/1957 2. Mumps 1 dose if born on or after 01/01/57; or positive Tier ; Exempt

How to fill out immunization form - dcccd

How to fill out immunization form - dcccd:

1. Start by obtaining the immunization form from the dcccd website or the appropriate healthcare provider.
2. Fill in personal information such as your full name, date of birth, and student ID number.
3. Provide your contact information including phone number and email address.
4. Indicate your current address and any previous addresses if applicable.
5. Specify your citizenship status and provide a copy of relevant documentation if required.
6. List any previous immunizations you have received, including the vaccine name, dates administered, and the healthcare provider who administered them.
7. If you have not received any immunizations, leave the appropriate sections blank or indicate that you are exempt for medical or religious reasons.
8. Attach copies of any official immunization records or medical exemptions, if applicable.
9. Review the form for accuracy and completeness before submitting it.
10. Submit the completed form according to the instructions provided, either online or in person.

Who needs immunization form - dcccd?

1. All students attending classes at dcccd campuses are required to submit an immunization form.
2. This includes both full-time and part-time students, as well as students taking online or remote courses.
3. The immunization form ensures that students have received the necessary vaccinations to protect themselves and others from preventable diseases.
4. Some programs or courses may have additional immunization requirements, so it is important to check with the specific dcccd campus or program for any additional forms or documentation needed.
5. Failure to submit the immunization form or meet the immunization requirements may result in registration holds or other enrollment restrictions.

For pdfFiller’s FAQs

What is immunization form - dcccd?

Immunization form - dcccd is a form used to document a student's vaccination history and ensure compliance with immunization requirements set by the Dallas County Community College District.

Who is required to file immunization form - dcccd?

All students enrolling in the Dallas County Community College District are required to file an immunization form.

How to fill out immunization form - dcccd?

Students can fill out the immunization form - dcccd by providing information on their vaccination history, including dates of vaccinations and types of vaccines received.

What is the purpose of immunization form - dcccd?

The purpose of the immunization form - dcccd is to ensure that students are up-to-date on their vaccinations and to prevent the spread of vaccine-preventable diseases on campus.

What information must be reported on immunization form - dcccd?

The information reported on the immunization form - dcccd typically includes the student's name, date of birth, vaccination dates, types of vaccines received, and healthcare provider information.

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