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Illinois immunization form health 2025

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The document outlines the immunization requirements for domestic students at Eastern Illinois University, including necessary vaccines, compliance policies, deadlines for submission, and procedures for reporting vaccination status. It emphasizes the importance of providing signed and dated records from a healthcare provider and details penalties for non-compliance.

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Click ‘Get Form’ to open the Illinois Immunization Form in the editor.
Begin by entering your personal information at the top of the form. Fill in your last name, first name, middle initial, birth date, gender, and E#.
Indicate the term you are entering EIU by selecting the semester and year from the dropdown menus.
In the Required Immunizations section, provide the month, day, and year for each vaccine listed. Ensure you include dates for DTP, Tdap, MMR, and Meningococcal vaccines as specified.
For Recommended Immunizations, fill in your COVID vaccination details including type and dates. Remember to check if you need to submit online or in person.
Ensure that a health care provider signs and dates the form at the bottom. This is crucial for compliance.
Review all entries for accuracy before saving or submitting your completed form through our platform.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (105 Votes)
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2018	4.2 Satisfied (52 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Do you need a doctors order for vaccines?

The date the vaccine is administered. The name, office address, title and signature (electronic is acceptable) of the person administering the vaccine. Initials of the vaccine administrator will suffice as long as the office keeps a record of the person to whom the initials refer.

Can I get a copy of my immunization records online in Illinois?

How do I access the IDPH Vax Verify portal (also known as Illinois Resident Immunization Portal) for my immunization record(s)? You can access your immunization records by visiting the Vax Verify portal.

Who can administer vaccines in New York?

Getting a vaccine at a doctors office or health department does not require a patient-specific prescription from another health care provider.

What are the health requirements for school in Illinois?

The State of Illinois requires immunizations, physcial examinations, eye and dental exams for children in school. These student health requirements apply to all schools in Illinois - public, charter or private. Noncompliance can result in a child being excluded from school.

Who can fill out my immunization form?

Should students or student health offices complete the form? Students should complete the AAMC Standardized Immunization Form in conjunction with either the student health office at their medical school or with their primary care provider.

immunization form for college

State of Illinois Certificate of Child Health Examination 2025 Illinois required vaccines for school State of Illinois Certificate of Child Health Examination pdf Immunization schedule Illinois State of Illinois physical form for adults Illinois school physical form 2025 Illinois vaccine portal State of Illinois Certificate of Child Health Examination form

What counts as proof of immunization?

Photocopies of immunization records from a licensed healthcare provider or clinic, or from a California K-12 school uploaded to My Health Portal. All records must show the vaccine type, dose, and date of each shot.

What immunizations are required in Illinois?

Proof of Immunity A combination of 3 shots for Tetanus/Diphtheria/Pertussis (DTP/Dtap/Td/ or Tdap). One of the three must be a Tdap. Two measles, mumps, rubella (MMR) vaccines given after one year of age and after December 31, 1967. One meningococcal conjugate vaccine for students age 21 or younger.