Bmcc immunization form 2026

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  1. Click ‘Get Form’ to open the bmcc immunization form in the editor.
  2. Begin with Part 1: Student Information. Fill in your name, date of birth, EMPL ID, daytime phone, and email address. Ensure all information is legible for processing.
  3. Move to Part 2: Immunization History. This section must be completed by a healthcare provider. Ensure that all dates include month, day, and year. Mark an (X) in the appropriate boxes for each vaccine received.
  4. In Part 3: Meningococcal Meningitis, check one box indicating your immunization status and sign in Section B if you are under 18 years old.
  5. Finally, review all sections for accuracy before submitting. You can easily save and share the completed form directly from our platform.

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Ask your doctor, pharmacist or other vaccine provider for an immunization record form or download and use this form [4 pages]. Bring this record with you to health visits, and ask your vaccine provider to sign and date the form for each vaccine you receive.
Submit your completed Student Immunization Record Form and/or existing vaccination records to the Wellness Center at wellness@gc.cuny.edu. A single PDF document attachment is preferred. You should submit your completed documents as early as possible to avoid potential delays in clearance for registration.
You will need to download and complete an MMR/Meningitis immunization form before you can register for classes. You will need to submit proof of two doses of measles, one of mumps and one of rubella. Submit a PDF via email to healthservices@bmcc.cuny.edu.
Current Grading System GradeDescriptionPoints D 63-66% 1.00 D- 60-62% 0.70 F Failure/Unsuccessful completion of the course. Student completed all course assignments and performed poorly to earn this grade. 0.00 R Course must be repeated; minimum level of proficiency not attained. 22 more rows
Please return your completed forms to Rm N-380 or email to healthservices@bmcc.cuny.edu. You may call our office at (212) 220-8256 for any additional information. When emailing the office, be sure to include your full name, DOB, and CUNYfirst ID#.

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Regular attendance means students have no more than 3 absences during the program session.
Project Impact provides students with direct services such as tutoring and mentoring and referrals to other services as needed. We refer our students to legal services, social services, counseling, employment, career opportunities and housing assistance.

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