Get the free MDPH Meningococcal Information and Waiver Form - westfield ma

This document provides information on meningococcal disease, the vaccination requirements for full-time students living in dormitories or similar housing in Massachusetts, and includes a waiver for

How to fill out mdph meningococcal information and

How to fill out MDPH Meningococcal Information and Waiver Form

1. Obtain the MDPH Meningococcal Information and Waiver Form from the appropriate health department website or office.
2. Read the instructions carefully to understand each section of the form.
3. Fill in the personal information section, including your name, date of birth, and contact information.
4. Provide information about your vaccination history, specifically regarding meningococcal vaccinations.
5. Review any statements or questions regarding the risks of meningococcal disease and the benefits of vaccination.
6. Sign and date the form to confirm that you understand the information provided.
7. Submit the completed form to the designated health office or institution as instructed.

Who needs MDPH Meningococcal Information and Waiver Form?

1. Students entering college or university who are required to have meningococcal vaccinations.
2. Parents of minors who need to provide the waiver for their child.
3. Individuals seeking to enroll in programs or institutions that mandate proof of meningococcal vaccination.

People Also Ask about

Is meningococcal meningitis vaccine mandatory?

At least 34 states and the District of Columbia require some type of vaccination for students who are attending college or university classes. For example: At least 22 states require meningococcal vaccine, with most requiring meningococcal vaccine for students living on campus.

What is an immunization waiver?

All states allow exemptions from school immunization requirements for children who are unable to receive vaccines for medical reasons. State laws vary regarding non-medical exemptions, for religious or personal reasons. Personal exemptions are also referred to as "philosophical exemptions" by some states.

How can I be exempt from meningitis vaccine?

Exemption is permitted with proof of immunity, non-medical exemption or birth before 1957. First-time enrollees at California State University and University of California must show proof of hepatitis B vaccine. All institutions with on-campus housing must provide information about meningococcal ACWY and B.

Why not to get the meningococcal vaccine?

There may be times when someone shouldn't get a meningococcal vaccine, like if they: Had a life-threatening allergic reaction after the vaccine. Have a life-threatening allergy to any part of the vaccine.

Is meningococcal vaccine mandatory?

Key points. CDC recommends meningococcal vaccination for all adolescents. CDC also recommends meningococcal vaccination for children and adults at increased risk for meningococcal disease. Follow the recommended immunization schedule to ensure that your patients get the meningococcal vaccines that they need.

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.

Can I get the meningitis vaccine for free?

Are free or low-cost meningococcal shots available? Yes, if you don't have insurance or your insurance does not cover the cost of the meningococcal vaccines, you may be able to find free or low-cost meningococcal shots. Note that there may still be an administration fee of up to $21.22 per shot.

What happens if I don't get the meningococcal vaccine?

Meningococcal disease is a very serious infection that can cause severe scarring, loss of limbs, brain damage and death. Vaccination is a safe and effective way to protect yourself from meningococcal disease.

For pdfFiller’s FAQs

What is MDPH Meningococcal Information and Waiver Form?

The MDPH Meningococcal Information and Waiver Form is a document that provides information about meningococcal disease and vaccines, and allows individuals or guardians to waive vaccination requirements if they choose.

Who is required to file MDPH Meningococcal Information and Waiver Form?

Individuals who are entering certain educational institutions, particularly college or university students residing in dormitories, are required to file the MDPH Meningococcal Information and Waiver Form.

How to fill out MDPH Meningococcal Information and Waiver Form?

To fill out the MDPH Meningococcal Information and Waiver Form, provide personal identification details, review the information provided about meningococcal disease, and indicate whether you are choosing to accept or waive the vaccination, then sign and date the form.

What is the purpose of MDPH Meningococcal Information and Waiver Form?

The purpose of the MDPH Meningococcal Information and Waiver Form is to ensure individuals are informed about the risks associated with meningococcal disease and to document their decision regarding vaccination.

What information must be reported on MDPH Meningococcal Information and Waiver Form?

The MDPH Meningococcal Information and Waiver Form requires reporting of personal information such as the individual's name, date of birth, contact information, vaccination status, and whether they are waiving the vaccine.