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UNIVERSITY HEALTH SERVICES 128 STUDENT HEALTH CENTER UNIVERSITY PARK, PA 16802 PHONE (814) 8652398 FAX (814) 8659309FOR US USE ONLY: Please check a box, initial & date Approved Temporarily Approved

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How to fill out meningococcal meningitis waiver request

01

Obtain a copy of the meningococcal meningitis waiver request form from the appropriate institution or organization.

02

Fill out the form completely and accurately with all required information, including personal details and medical history.

03

Provide any necessary supporting documentation, such as medical records or a doctor's note, if required.

04

Submit the completed form and any additional documentation to the designated office or individual for review and approval.

05

Await a response from the institution regarding the status of your waiver request.

Who needs meningococcal meningitis waiver request?

01

Individuals who are required to have a meningococcal meningitis vaccination but have a valid medical reason to request a waiver.

02

Students or employees of institutions that mandate meningococcal meningitis vaccination for enrollment or employment.

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What is meningococcal meningitis waiver request?

The meningococcal meningitis waiver request is a form submitted to waive the vaccination requirement for meningococcal meningitis.

Who is required to file meningococcal meningitis waiver request?

Individuals who are unable to receive the meningococcal meningitis vaccination due to medical reasons or personal beliefs are required to file the waiver request.

How to fill out meningococcal meningitis waiver request?

To fill out the waiver request, individuals must provide documented proof of the medical reason or personal belief that prevents them from receiving the vaccination.

What is the purpose of meningococcal meningitis waiver request?

The purpose of the waiver request is to grant individuals an exemption from the meningococcal meningitis vaccination requirement.

What information must be reported on meningococcal meningitis waiver request?

The waiver request must include the individual's full name, date of birth, medical reason or personal belief for the exemption, and any supporting documentation.

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