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CUNY Hunter College Immunization Record Form 2023-2025 free printable template

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Hunter City University of New YorkIMMUNIZATION RECORD FORM Immunization records are required prior to registrationUpload this form and your proof to the Student Repository/ CUNYfirst Document Uploader If
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How to fill out immunization record form immunization

01
Obtain a copy of the immunization record form from the healthcare provider or school.
02
Provide personal information such as name, date of birth, and contact information.
03
List all immunizations received, including dates and types of vaccines.
04
Include information about any exemptions or waivers if applicable.
05
Sign the form and submit it to the designated recipient.

Who needs immunization record form immunization?

01
Anyone who has received immunizations and needs to provide proof of vaccination for school, work, travel, or other purposes.
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Proof of immunity to Measles, Mumps, Rubella (MMR) and a response to the status of Meningococcal Meningitis vaccination are required of all new incoming students. You are NOT permitted to register for classes without proof of immunization.
All students (except those with approved exemptions or exceptions) must be “fully vaccinated” to enter any CUNY facility.
Go to the Med+Proctor website or search for “Immunization Compliance” in One. IU to create an account and upload proof of compliance. Once you create a Med+Proctor account, you will have two options for submitting your documentation: Pay a one-time fee of $10 for lifetime access to any immunization records you upload.
Log into the Student Self-Service Portal and proceed to the Enter Dates screen under Immunization. Follow the page instructions to enter your vaccine and/or titer dates. Upload the immunization form and supporting lab reports. Allow one week for verification to take place.
Please return completed immunization forms to the Office of the Registrar by one of the following methods: Mail: ISU Office of the Registrar - 200 North 7th Street, Parsons Hall 009, Terre Haute, Indiana 47809. Secure Upload. Fax: (812) 237-8039.
All students, faculty and staff must be vaccinated or tested before coming to campus.

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The immunization record form is a document that lists all the vaccines a person has received.
Individuals of all ages are required to have an immunization record form on file, especially children who are attending school.
To fill out the form, you need to list the vaccines you have received and the dates of administration.
The purpose of the form is to keep track of which vaccines individuals have received to ensure they are up to date on their immunizations.
The form must include the name of the vaccine, the date it was administered, and the healthcare provider who administered it.
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