Campbell university immunizations form 2026

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  1. Click ‘Get Form’ to open the Campbell University Immunizations Form in our editor.
  2. Begin by filling out your personal information in the designated fields, including your last name, first name, middle name, date of birth, and social security number. Ensure all entries are clear and legible.
  3. Proceed to Section A where you will indicate your immunization history according to age. Carefully check the appropriate boxes for each required vaccine and provide the dates of administration.
  4. In Section B, record any recommended immunizations you have received. If applicable, include details about the meningococcal vaccine and any tuberculin tests for international students.
  5. Complete Section C by listing any optional immunizations you may have received. Make sure to provide accurate dates for each entry.
  6. Finally, ensure that a physician or clinic representative signs and stamps the form in the designated area before submission.

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Immunization Recommendations for College Students Influenza vaccine. Measles, mumps, rubella (MMR) vaccine. Meningococcal quadrivalent (ACWY) vaccine. Serogroup B meningococcal vaccine. Meningococcal pentavalent (MenABCWY) vaccine. Mpox vaccine. COVID-19 vaccine. Human papillomavirus (HPV) vaccine.
All vaccines administered should be fully documented in the patients permanent medical record. Health care providers who administer vaccines that are covered by the National Vaccine Injury Compensation Program are required by law to ensure the permanent medical record of the recipient indicates: Date of administration.
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.
Take copy of your shot records to your county health department- they will usually sign off on your college paperwork free of charge.
Go to My Record Health Summary and select the Immunizations tab. You can see the immunizations youve received and the dates on which you received them. Click the immunization name to learn more. If your immunizations are not up to date, please docHub out to your clinic directly to have your information updated.

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Two ways to submit the Certificate of Immunization and supporting documentation: Upload to the online patient portal (preferred method). Click here for portal upload instructions. Or, mail to Immunization Office, 4400 University Drive, MS 2D3, Fairfax VA, 22030.
call the CDC Information Contact Center at 800-CDC- INFO (232-4636). Congratulations! Now you should take the records to your provider or local public health clinic and ask them to document this information on an official record, and, if possible, in the state or local immunization registry.

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