CSU Immunization form - Charleston Southern University - csuniv 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your full name and Student ID# in the designated fields at the top of the form.
3. Fill in your Date of Birth using the provided format (MM/DD/YYYY).
4. Complete the required immunization sections, starting with M.M.R. Enter the dates for both doses as specified.
5. Proceed to Tetanus-Diphtheria and Hepatitis B sections, ensuring you provide all necessary dates for each dose.
6. For Tuberculosis Screening, indicate your PPD test result and date. If positive, include chest X-ray results.
7. Continue filling out Polio and Varicella sections, providing either vaccination dates or history as applicable.
8. Finally, complete the Influenza and Meningococcal sections with appropriate dates.
9. Sign and date the form at the bottom, ensuring a licensed health care provider's signature is included.

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