QF222. Immunization Verification Form for Holland College Healthcare Programs 2025

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The document outlines the Immunization Verification Form required for students enrolling in healthcare programs at Holland College. It details the necessary immunizations and tuberculosis screening that must be completed within 12 months prior to the program start date. The form must be filled out by a physician or public health official, confirming that the student meets the immunization requirements essential for participation in clinical practice settings. The document emphasizes the importance of these vaccinations for health care workers to prevent exposure to communicable diseases.

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Click ‘Get Form’ to open the QF222 in our editor.
Begin by entering your personal information in the designated fields, including your name, phone number, and address.
Provide your month and year of birth in the specified format to ensure accurate identification.
Review the immunization requirements listed on the form. For each vaccine, indicate whether you meet the requirements by selecting 'Yes' or providing additional details as necessary.
Ensure that a physician or public health official completes the declaration section after reviewing your immunization records. They must sign and date this section.
Finally, save your completed form and submit it to Holland College Admissions Office along with your acceptance documents.

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