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How to use or fill out MIDDLE TENNESSEE STATE UNIVERSITY REQUIRES FULL-TIME STUDENTS TO PROVIDE PROOF OF TWO (2) DOSES OF with our platform
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Click ‘Get Form’ to open it in the editor.
In Part I, enter your full name, date of birth, and student ID number. Ensure all information is accurate for proper identification.
Proceed to Part II, which must be completed by a physician. This section includes vaccination details for Varicella and MMR. Check the appropriate boxes based on your immunization status.
If you have had the diseases confirmed by medical records, select the corresponding options and provide dates as required.
For any medical contraindications, clearly list the reasons in the designated area provided by your healthcare provider.
Ensure that your healthcare provider fills in their name, address, and signature before submitting the form.
Once completed, save your document and submit it via email or fax to MTSU Health Services as instructed.
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Vaccination Requirements Mumps; Measles; Rubella; Polio; Tetanus and Diphtheria Toxoids; Pertussis; Haemophilus influenzae type B; Hepatitis B; and.
Which vaccines are legally required?
Important Information Regarding Medical Records Required immunizations include two MMRs (measles, mumps, rubella) and completion of MSUs Tuberculosis Screening Form. Forms can be found at the Student Wellness website.
How many vaccines do you need for college?
By law, the following information must be documented on the patients paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.
What vaccines does MTSU require?
Students entering any college or university must show proof of immunity against tetanus, diphtheria, pertussis, MMR, hepatitis B, and varicella.
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Required Immunizations Tuberculosis Screening. IMPORTANT: This form is two pages. Meningitis MCV4 Serogroups A,C,W-135, Y. Only for students living on campus. Varicella (Chicken Pox) MMR (Measles, Mumps and Rubella) Hepatisis B/Meningitis. If student is under the age of 18, this must be completed by a parent.
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I have a two-part question for Dr. Gitterman. The first one, I think, is sort of related to the issues that Dr. Blumberg just brought up. I think
All students born on or after. January 1, 1980 must provide proof of immunization with two doses of Varicella vaccine at least. 28 days apart, serology (titer).
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