Southern university immunization form 2025

1. Click ‘Get Form’ to open the southern university immunization form in the editor.
2. Begin by entering your personal information at the top of the form. Fill in your first name, middle name, last name, address, city, state, zip code, and student identification number.
3. Select the term you are applying for by checking either Fall, Spring, or Summer.
4. In the section for immunizations, provide details for each required vaccine: Measles, Rubella, Mumps, Meningococcal, and Tetanus-Diphtheria. Enter dates for each immunization received or indicate if a serologic test was performed.
5. If applicable, explain any reasons for not receiving vaccinations in the designated area. Choose from options such as personal reasons or medical exemptions.
6. Ensure that a physician or health care provider completes their section by providing their name, signature, date, and contact information.
7. Finally, review all entered information for accuracy before saving and submitting your completed form.

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