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Child and Teen Immunization Questionnaires Name ___ First Name ___ Middle Initial___ Date of Birth ___/___/___Age___Male/FemaleRace___Street Address___ City ___ State___ Zip Code___ Phone Number ___

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How to fill out immunization record - umd

01

Gather all necessary information such as full name, date of birth, and address.

02

Ensure the immunization record form provided by the University of Maryland (UMD) is completed accurately.

03

List all immunizations received including the type of vaccine, date administered, and healthcare provider information.

04

Make sure the record is signed and dated by a healthcare provider or authorized personnel.

05

Submit the completed immunization record to the designated office at UMD for review and approval.

Who needs immunization record - umd?

01

All students enrolled at the University of Maryland (UMD) are required to have an up-to-date immunization record on file.

02

Faculty and staff who have direct contact with students or work in healthcare settings may also be required to provide an immunization record.

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What is immunization record - umd?

Immunization record - umd is a document that contains a record of a person's vaccinations and immunizations received at the University of Maryland.

Who is required to file immunization record - umd?

All students enrolled at the University of Maryland are required to file their immunization records.

How to fill out immunization record - umd?

To fill out the immunization record - umd, students need to provide documentation of their vaccinations and immunizations through the university's online portal.

What is the purpose of immunization record - umd?

The purpose of the immunization record - umd is to ensure that all students are properly vaccinated to prevent the spread of communicable diseases on campus.

What information must be reported on immunization record - umd?

The immunization record - umd must include the student's name, date of birth, list of vaccinations received, dates of vaccinations, and healthcare provider's signature.

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