Certificate of Compliance - Health Center - University of Mississippi - healthcenter olemiss 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the designated fields: Last, First, and Middle. Ensure accuracy as this information is crucial for identification.
3. Input your Social Security Number and Date of Birth in the respective fields. This information is necessary for verification purposes.
4. Fill out the vaccination history section. Enter the dates for your first and second MMR vaccinations, or provide details for individual vaccines (Rubeola, Rubella, Mumps) if applicable.
5. If you are providing proof of immunity through serologic testing or previous infections, attach copies of lab results or office records as required.
6. Complete the section regarding other recommended immunizations by entering the last dates for DT/DTaP, Polio, Hepatitis B Series, Meningitis, and Varicella.
7. Ensure that all documentation is signed by a physician or authorized health care provider and includes their office stamp with address.
8. Finally, return the completed form to The University of Mississippi Student Health Service at the provided address.

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