Bacterial Meningitis Vaccination Exemption Form (For Students an - tccd: Fill out & sign online

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Click ‘Get Form’ to open the Bacterial Meningitis Vaccination Exemption Form in the editor.
Begin by entering your personal information in the designated fields, including your name, TCC ID, home address, telephone number, and TCC email.
Next, read through the exemption options carefully. Place an 'X' next to the exemption you are requesting: either for health reasons or reasons of conscience.
If claiming a health-related exemption, ensure you attach a signed affidavit or certificate from a physician stating that vaccination would be injurious to your health.
For a conscience-based exemption, attach a notarized Texas Department of State Health Services exemption form. Remember that this exemption is valid for only 2 years.
Finally, sign and date the form before submitting it to your Campus Registrar.

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