Charleston Southern University - Your Passport to Purpose 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your full name and student ID number in the designated fields at the top of the form.
3. Fill in your date of birth accurately, ensuring the format is correct.
4. Complete sections A-F with your immunization records. For each required immunization, provide the dates of administration as specified.
5. If applicable, indicate your history with Varicella and provide details on any vaccinations received.
6. For Tuberculosis screening, select the appropriate test type and record the results along with the test date.
7. Ensure that a licensed health care provider signs and dates the form at the bottom before submission.

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