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THE UNIVERSITY OF MISSISSIPPI Certificate of Compliance To be completed 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your date of birth (DOB) and full name at the top of the form.
- Fill in the details for your first and second MMR vaccinations, including month, day, and year.
- If applicable, provide information for Rubeola, Mumps, and Rubella vaccinations by filling in the respective dates.
- Indicate if you are providing proof of immunity through blood testing or medical records by checking the appropriate boxes.
- Complete any additional recommended immunizations section with relevant dates.
- Ensure that a physician or authorized health care provider signs the document and includes their office stamp with address.
- Once complete, upload this form to Med+Proctor as instructed or return it to The University of Mississippi Health Service.
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| 2024 | 4.4 Satisfied (31 Votes) |
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