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How do I fill this out?
Filling out this form is straightforward. Begin by entering your personal information as requested. Follow the immunization requirements carefully to ensure all necessary doses and reports are included.

How to fill out the Immunization and Health Records Required by Penn University?
1
Read the entire form to understand the requirements.
2
Fill in your personal and health information as required.
3
Attach relevant documents such as reports and vaccination cards.
4
Ensure all immunization dates are accurately reported.
5
Review your form for completeness before submission.
Who needs the Immunization and Health Records Required by Penn University?
1
Incoming students who need to fulfill public health requirements.
2
International students needing to prove their immunization status.
3
Students with prior medical conditions who need specific vaccinations.
4
Music students at Curtis Institute who need to comply with health regulations.
5
Transfer students required to provide updated immunization records.
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Editing this PDF on PrintFriendly is simple and efficient. You can customize your form details directly within the PDF editor. Once you have made your changes, be sure to save the modified document for submission.
1
Upload your PDF document into the PrintFriendly editor.
2
Navigate through the fields to enter or modify your personal information.
3
Attach any required documents through the editor interface.
4
Review all changes and ensure the information is accurate.
5
Download the edited PDF for submission.

What are the instructions for submitting this form?
To submit this form, email the completed document to Dean Tarditi at meredith.tarditi@curtis.edu, and ensure to bring paper originals to campus. You may also fax the records if required. Make sure to meet the submission deadline of July 1, 2022, to ensure your compliance with health requirements.
What are the important dates for this form in 2024 and 2025?
The key submission deadline for this immunization form is July 1, 2022. Ensure all required documents are submitted by this date for enrollment. Compliance with these health regulations is critical for all incoming students.

What is the purpose of this form?
The main purpose of the immunization form is to ensure that all students have received the required vaccinations before entering the university. This process helps maintain a healthy campus environment by preventing outbreaks of communicable diseases. It also aligns with public health policies that protect both students and staff.

Tell me about this form and its components and fields line-by-line.

- 1. Last Name: Your family name.
- 2. First Name: Your given name.
- 3. Email: Your personal or school email address.
- 4. Vaccination History: Details of vaccinations received, including dates.
- 5. Healthcare Provider Signature: Signature from a licensed healthcare provider.
What happens if I fail to submit this form?
If you fail to submit this form, you may not be able to enroll for classes or participate in certain campus activities. Missing this requirement could lead to additional health checks or restrictions on campus.
- Enrollment Delays: Failure to submit on time may postpone your enrollment process.
- Health Compliance Issues: Non-compliance with health regulations could hinder your campus participation.
- Additional Health Checks: You may be required to undergo additional health screenings.
How do I know when to use this form?

- 1. Enrollment Process: Required for enrollment in the university.
- 2. Public Health Requirement: To meet public health and safety standards.
- 3. Campus Participation: Necessary for participation in campus activities.
Frequently Asked Questions
What is the purpose of this immunization form?
This form is required to document student vaccinations to comply with health regulations.
How do I submit this immunization form?
Submit the completed form via email to the designated recipient.
Who needs to fill out this form?
All incoming students, including transfer and international students, must complete this form.
What documents do I need to attach?
Attach vaccination cards and any relevant health reports as specified.
When is the submission deadline?
The submission deadline for this form is July 1, 2022.
Can I edit this PDF online?
Yes, you can edit your PDF using the PrintFriendly editing features.
How can I sign the PDF?
You can sign your PDF using the digital signing option available on PrintFriendly.
Can I share my completed form?
Yes, PrintFriendly allows you to share your completed form easily.
What if I have questions while filling out the form?
Refer to your healthcare provider for assistance with filling out the form.
What happens if I miss the submission deadline?
Failure to submit by the deadline may result in not meeting health compliance requirements.
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