Immunization Record Form. Required form for all Hunter students that documents vaccinations 2025

1. Click ‘Get Form’ to open it in our editor.
2. Begin with Part 1: Student Information. Fill in your last name, first name, middle initial, date of birth, CUNY EMPL ID, daytime phone number, and email address. Ensure all information is accurate and legible.
3. Proceed to Part 2: Immunization History. This section must be completed by a health care provider. Make sure to include all required documentation and have the provider sign and stamp the form.
4. In Part 3: Meningococcal Meningitis, check one box that applies to your situation regarding immunization status and provide your signature and date.
5. Review the entire form for completeness before submission. You can submit it in person, via fax, or email as specified in the instructions.

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