Get the free HEALTH IMMUNIZATION bFORMb Western Technical College bb - westerntc
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HEALTH IMMUNIZATION FORM Western Technical College (revised March 2016) THIS FORM MUST BE SIGNED BY A HEALTH CARE PROFESSIONAL (PHYSICIAN, NURSE PRACTITIONER, PHYSICIAN ASSISTANT, NURSE OR MEDICAL
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How to fill out health immunization bformb western
How to fill out the Health Immunization Form at Western:
01
Obtain the form: You can get the Health Immunization Form from the Western Health Services office or download it from their website.
02
Provide personal information: Fill in your name, student ID number, date of birth, and contact information in the appropriate fields.
03
Vaccination history: Indicate the vaccines you have received in the past by checking the corresponding boxes or writing down the dates and the type of vaccine.
04
Immunization records: Attach any official immunization records you have, such as a CDC vaccination card or records from your healthcare provider.
05
Tuberculosis screening: Answer the questions regarding tuberculosis screening, including whether you have had a PPD test or chest X-ray for TB and the results.
06
Meningococcal vaccination: If you are under 21 years old, indicate whether you have received the Meningococcal vaccination or not.
07
Signature: Sign and date the form to certify the information you provided is accurate.
08
Return the form: Submit the completed form to the Western Health Services office or follow the instructions provided to submit it online.
Who needs the Health Immunization Form at Western:
01
All incoming students: It's mandatory for all new students enrolling at Western to provide their immunization records by filling out the Health Immunization Form.
02
International students: In addition to the general requirement, international students must meet specific immunization requirements set by Western's Health Services.
03
Students living in on-campus housing: If you will be residing in the university's on-campus housing, you must submit the Health Immunization Form to ensure a safe and healthy living environment.
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What is health immunization form western?
Health immunization form Western is a document used to record and report an individual's vaccination history.
Who is required to file health immunization form western?
All students, staff, and faculty at Western are required to file a health immunization form.
How to fill out health immunization form western?
To fill out the health immunization form Western, you must provide information about the vaccines you have received, including dates and types.
What is the purpose of health immunization form western?
The purpose of health immunization form Western is to ensure that the university community is protected against preventable diseases.
What information must be reported on health immunization form western?
The information that must be reported on health immunization form Western includes the name of the vaccine, date of administration, and the healthcare provider.
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