Measles Immunization Documentation Form
In order to protect the health and safety of all members of a school campus, a college or university may adopt immunization requirements for infectious diseases such as measles and rubella as recommended by the Centers for Disease Control or a local health department.
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To meet health requirements, college students will be required to submit the immunization record before attending school. The Measles Immunization Documentation Form app provides students with a form to report measles-rubella immunization records or immunity. With the app, students can select from four different options. The first three options indicate the student's protection against the illness including that student was vaccinated with the required dose of MMR or Rubeola Vaccine in two immunizations, a healthcare provider confirms that student had the Rubeola Measles vaccine or a confirmation that the student had a blood test that indicated measles immunity. These options should include the signature of the primary physician or health care provider who administered the vaccine. The fourth option is a measles immunization waiver for those declining to be vaccinated. The student signing the waiver acknowledges exposure risks and understanding of protocol if a case of measles should arise on the school campus.
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