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Student Health ServicesREQUEST FOR RELIGIOUS EXEMPTION: MMR IMMUNIZATION FOR MINORS (YOUNGER THAN 18 YEARS) New York State public health law 2165 and University policy requires that all students document

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How to fill out notification of student immunization

01

Gather all required information such as student's name, date of birth, grade level, and vaccination record.

02

Fill out the student's personal information on the top portion of the form.

03

Provide details of each vaccination received by the student including the type of vaccine, date administered, and healthcare provider.

04

Sign and date the form as the person completing the notification.

05

Submit the completed notification of student immunization to the appropriate school authority or health department.

Who needs notification of student immunization?

01

Parents or guardians of school-aged children

02

School health services department

03

Health department officials

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What is notification of student immunization?

Notification of student immunization is a document that confirms that a student has received the necessary immunizations or exemptions required for school enrollment.

Who is required to file notification of student immunization?

Parents or guardians are typically required to file notification of student immunization for their children.

How to fill out notification of student immunization?

Notification of student immunization can usually be filled out by providing information about the student's immunization history or exemptions.

What is the purpose of notification of student immunization?

The purpose of notification of student immunization is to ensure that all students attending school are protected from certain vaccine-preventable diseases.

What information must be reported on notification of student immunization?

The information reported on notification of student immunization typically includes the student's name, date of birth, vaccine doses received, and any exemptions claimed.

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