University of Texas at San Antonio Meningococcal Meningitis Vaccine Requirement Form 2013-2024 free printable template

1 For UTSA Student Health Services Office Use Only Date Rec d: Staff Initials: Immunized Waiver Requirement Completion Date: The University of Texas at San Antonio Student Health Services One UTSA

How to fill out utsa meningitis vaccine form

How to fill out UTSAM meningitis vaccine form:

1. Obtain the UTSAM meningitis vaccine form from the appropriate source, such as the UTSAM health center or the university website.
2. Fill in your personal information accurately, including your full name, date of birth, and contact information.
3. Provide your student ID number or any other identification required by the form.
4. Indicate your gender and ethnicity as requested.
5. Fill out the section that asks for your current immunization status. If you have received the meningitis vaccine in the past, provide the date and location of the vaccination. If you have not received the vaccine, leave this section blank.
6. Answer any additional questions on the form regarding your medical history, allergies, and previous vaccinations.
7. Sign and date the form to certify the information provided is accurate.

Who needs UTSAM meningitis vaccine form:

1. All students who are enrolling in or applying to the University of Texas at San Antonio (UTSA) are required to submit the UTSAM meningitis vaccine form.
2. This form ensures that students have received the mandatory meningitis vaccine to protect their health and the health of the campus community.
3. It is important to complete and submit this form before the specified deadline to avoid any enrollment or application issues.

People Also Ask about utsa meningitis vaccine form

How common is meningitis B in college?

MenB is more common among those 16-23 and is 5+ times more likely in college students. Yet few colleges are requiring the Meningitis B vaccine. There are 5,300 colleges and universities, and more than 30,000 high schools in the United States. We only know of 40+ schools currently requiring Meningitis B vaccination.

Where to get meningitis vaccine Texas?

The Texas State Student Health Center offers meningococcal vaccinations. Appointments for the vaccination can be made online or by calling 512.245. 2161 to make an appointment.

Why do college students get meningitis B?

Why are College-Aged Students More Vulnerable to Meningitis B? Because Meningitis B can spread quickly among those living in close proximity to each other in residence halls and dorm rooms, college students are at a higher risk for contracting the illness.

Is meningitis B vaccine necessary?

Meningococcal B vaccines are recommended for people 10 years or older who are at increased risk for serogroup B meningococcal disease, including: People at risk because of a serogroup B meningococcal disease outbreak. Anyone whose spleen is damaged or has been removed, including people with sickle cell disease.

How do I submit proof of meningitis to UTSA?

We only accept originals (no copies) of the official Texas Department of State Health Services (TDSHS) form. The TDSHS form must be completed, notarized, and sent to Wellness 360 within 90 days from the date it was notarized.

Which meningitis vaccine is required for college in Texas?

In Texas, one dose of MCV4 given at or after age 11 years is required for children in 7th-12th grades. One dose of MCV4 received in the previous five years is required in Texas for those under the age of 22 years and enrolling in college.

Should my college freshman get the meningitis B vaccine?

The MenACWY vaccine is recommended for college freshman living in a dormitory. The vaccine has been recommended for 11-12 year olds since 2005, so it is possible that incoming freshmen have already received a dose. If you received a dose before age 16, you should get a booster before you go to college.

Does everyone get the meningitis B vaccine?

Who should get the meningococcal vaccines? All children ages 11 through 12 years should receive meningococcal vaccine (MenACWY) followed by a booster dose at age 16 years. Vaccination is also recommended for all adolescents ages 13 through 18 years who did not receive a dose at age 11-12 years.

For pdfFiller’s FAQs

What is utsa meningitis vaccine form?

The UTSB (University of Texas at San Antonio) meningitis vaccine form is a document that students are required to submit in order to provide proof of immunization against meningococcal meningitis. The form typically includes sections for personal information, vaccination details (including the date, brand, and lot number of the vaccine), and healthcare provider information. Students may need to complete this form and submit it to the university's health services or compliance office before enrolling in classes or living on campus, as many institutions have policies mandating meningitis vaccination.

How to fill out utsa meningitis vaccine form?

To fill out the UTSA meningitis vaccine form, follow these steps: 1. Download the meningitis vaccine form from the UTSA website or obtain a physical copy from the university's Health Services office. 2. Read the form thoroughly and make sure you understand all the information required. 3. Provide personal information: Fill in your full name, date of birth, student ID number (if applicable), and contact information. 4. Immunization history: Enter the dates of your meningitis vaccines or indicate if you have not received the vaccine. Include the name of the vaccine administered (e.g., Menactra, Menveo). 5. Healthcare provider information: Write the name, address, and contact details of the healthcare provider who administered the vaccine. 6. Certification: Sign and date the form to confirm that the information provided is accurate to the best of your knowledge. 7. Submitting the form: Once completed, submit the form as per the instructions provided by UTSA. This may involve uploading it to the UTSA Health Portal, mailing it, or submitting it in person at the designated office. Remember to check the UTSA website or contact the university's Health Services office for any specific guidelines or additional requirements related to filling out the meningitis vaccine form.

What is the purpose of utsa meningitis vaccine form?

The purpose of the UTSA meningitis vaccine form is to ensure that all students attending the University of Texas at San Antonio (UTSA) are vaccinated against meningococcal disease or have a valid exemption. Meningococcal disease is a potentially life-threatening infection that can lead to meningitis, an inflammation of the membranes surrounding the brain and spinal cord. The vaccine form helps UTSA keep track of student immunization records and promotes the health and safety of the campus community by reducing potential outbreaks of meningococcal disease.

What information must be reported on utsa meningitis vaccine form?

The specific information that must be reported on the UTSA meningitis vaccine form may vary depending on the institution's requirements and guidelines. However, generally, the following information may be required: 1. Personal Information: Name, date of birth, gender, student identification number or social security number, and contact details (phone number, address, email). 2. Vaccine Details: Information about the meningitis vaccine received, such as the vaccine name (e.g., Menactra, Menveo), date administered, lot number, and the number of doses. 3. Healthcare Provider Information: Name, address, and contact details of the healthcare provider or clinic where the vaccine was administered. 4. Signature and Date: The student's signature and the date the form is completed. It is always recommended to review the specific requirements on the meningitis vaccine form provided by UTSA or contact the university's health services department for accurate information.

What is the penalty for the late filing of utsa meningitis vaccine form?

The penalty for the late filing of the UTSA meningitis vaccine form can vary depending on the policies and regulations set by the university or institution. It is recommended to check with the specific university or institution to understand their policies and potential penalties for late submission.

How can I manage my utsa meningitis vaccine form directly from Gmail?

pdfFiller’s add-on for Gmail enables you to create, edit, fill out and eSign your utsa meningitis vaccine form and any other documents you receive right in your inbox. Visit Google Workspace Marketplace and install pdfFiller for Gmail. Get rid of time-consuming steps and manage your documents and eSignatures effortlessly.

How can I get utsa meningitis vaccine form?

The pdfFiller premium subscription gives you access to a large library of fillable forms (over 25 million fillable templates) that you can download, fill out, print, and sign. In the library, you'll have no problem discovering state-specific utsa meningitis vaccine form and other forms. Find the template you want and tweak it with powerful editing tools.

Can I edit utsa meningitis vaccine form on an Android device?

The pdfFiller app for Android allows you to edit PDF files like utsa meningitis vaccine form. Mobile document editing, signing, and sending. Install the app to ease document management anywhere.