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How to use or fill out the Health Certification form as a medical student
- Click ‘Get Form’ to open it in our editor.
- Begin by entering your WSU Banner ID and personal details, including your name, date of birth, local address, and contact information.
- In the Immunizations/Assessment of Immunity section, list the dates of your vaccinations and document any quantitative (IgG) titers for measles, mumps, rubella, varicella, and hepatitis B.
- Ensure that your healthcare provider completes the Health Assessment section with their findings and signature.
- Sign the Authorization for Release of Immunization/Immunity Testing Records to allow necessary information sharing with clinical facilities.
- Review all entries for accuracy before submitting. You can send the completed form via email or fax as specified in the instructions.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2016 | 4.8 Satisfied (32 Votes) |
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