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How do I fill this out?
To fill out this form, begin by gathering your immunization records. Ensure you have the necessary documents for each vaccine listed. Once ready, complete the form legibly and submit it as directed.
How to fill out the Mandatory Immunization Health History Form?
1
Gather all required immunization records.
2
Complete the form with accurate and legible information.
3
Ensure you include lab reports for titers.
4
Review the submission instructions carefully.
5
Submit the completed form before the deadline.
Who needs the Mandatory Immunization Health History Form?
1
Health profession students must submit this form to comply with enrollment requirements.
2
International students need to ensure they are screened for tuberculosis.
3
Students born after 1956 must provide proof of immunizations for MMR.
4
Pharmacy students require proof of immunization for specific vaccines.
5
Nursing students must complete all health compliance forms to participate in clinicals.
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1
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2
Select the 'Edit' option to enter the editing mode.
3
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4
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Save the edited document to your device.
What are the instructions for submitting this form?
To submit the Mandatory Immunization Health History Form, you can email it to healthcompliance@shcc.ufl.edu or fax it to (352) 392-0938 without a cover sheet. Alternatively, you can mail the document to the UF Student Health Care Center, Health Compliance Office, P.O. Box 117500, Gainesville, FL 32611-7500. Ensure that you include your UFID and keep a copy for your records.
What are the important dates for this form in 2024 and 2025?
Be aware of the submission deadlines for the immunization form specific to your health program in 2024 and 2025. Students must submit their forms prior to orientation and registration periods. Keep track of the annual immunization requirements as outlined by the institution.
What is the purpose of this form?
The primary purpose of the Mandatory Immunization Health History Form is to ensure that students have received all the necessary vaccinations required for enrollment in health profession programs. This form helps protect both the student and the community from vaccine-preventable diseases. By collecting this information, the institution can maintain compliance with public health guidelines.
Tell me about this form and its components and fields line-by-line.
- 1. Name: The full name of the student.
- 2. Date of Birth: The birthdate of the student.
- 3. Health Profession: The specific health program the student is enrolled in.
- 4. Vaccine Name: Names of vaccines administered including MMR, Hepatitis B, etc.
- 5. Dates of Vaccination: The dates on which each vaccine was received.
- 6. Results of Tuberculosis Screening: Details regarding the TB test and any necessary lab results.
- 7. Physician's Signature: Signature of an authorized health professional verifying the provided information.
What happens if I fail to submit this form?
Failure to submit this form may result in the inability to register for classes or participate in health programs. It is crucial for students to adhere to deadlines for compliance. Missing documentation can delay enrollment and academic progress.
- Course Registration: Late submission may hinder your ability to register for courses.
- Health Compliance: Non-compliance may result in restrictions on participation in health programs.
- Health Risks: Failure to provide immunization records increases health risks for yourself and others.
How do I know when to use this form?
- 1. Enrollment in Health Programs: Students in programs like Nursing or Pharmacy must provide this form.
- 2. International Student Requirement: International students must submit this form to satisfy immigration health regulations.
- 3. Proof of Immunization Completion: Use this form to document your vaccine history for compliance.
Frequently Asked Question
How do I edit the PDF?
Click the 'Edit' button after uploading your document to access editing tools.
Can I save edited PDFs?
You can download your edited PDF directly to your device.
What if my immunization records are incomplete?
You should consult your healthcare provider to gather the necessary documentation.
Is there a deadline for submission?
Yes, ensure to submit your form before your program's deadline.
Can I submit the form electronically?
Yes, you can email or fax your completed form as per the instructions.
What vaccines are required?
The form lists several mandatory vaccines based on your health program.
Do I need to provide lab results?
Yes, all titers must be accompanied by a lab report.
Who can I contact for help?
Reach out to the health compliance office via email or phone.
What if I have a religious exemption?
You must complete the waiver form as indicated.
How do I check my immunization status?
Log into your UF account to verify your immunization checklist.
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