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CAMPUS BOX 1055 0222 STUDENT SUCCESS CENTER EDWARDSVILLE IL 620261055PHONE: (618) 6502842 FAX: (618) 6505839 cougar care side. Immunization INFORMATION FORM PART I: GENERAL INFORMATION TO BE COMPLETED
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How to fill out immunization information form

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To fill out the immunization information form, follow these steps:
02
Start by reading the instructions provided on the form carefully.
03
Write your personal information, such as your name, date of birth, and contact details, in the designated fields.
04
Provide information about your immunization history. This may include dates of previous vaccinations, the name of the vaccines received, and any relevant medical records.
05
If you are unsure about your immunization history, contact your healthcare provider for assistance.
06
Make sure to check the form for any additional requirements or sections that need to be completed.
07
Review the completed form for accuracy and make any necessary corrections before submitting it.
08
Once you have filled out the form completely and accurately, submit it to the relevant authority or healthcare provider.
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Keep a copy of the form for your records.

Who needs immunization information form?

01
Anyone who requires immunization should fill out the immunization information form.
02
This may include individuals of all ages, from infants to adults.
03
It is especially essential for children attending school or daycare, as well as individuals traveling to certain countries where specific vaccinations are required.
04
Healthcare professionals, students in healthcare-related programs, and individuals working in high-risk environments may also need to complete this form.
05
It is best to consult with your healthcare provider or the specific institution/organization requesting the form to confirm if you need to fill it out.
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Immunization information form is a document used to record and report a person's vaccination history.
Parents, guardians, healthcare providers, and schools are required to file immunization information forms.
Immunization information form can be filled out by providing details of the vaccines received, dates of vaccination, and any exemptions.
The purpose of the immunization information form is to track and ensure individuals are up-to-date with their vaccinations.
Information such as vaccine name, dose, date administered, and any exemptions must be reported on the immunization information form.
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