Edit, Download, and Sign the Vaccination Documentation Worksheet for U.S. Immigrants
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How do I fill this out?
To fill out this form, begin by entering the applicant's personal information at the top. Next, chronologically list the vaccination details in the designated sections. Ensure that all entries are complete and accurate before submitting.

How to fill out the Vaccination Documentation Worksheet for U.S. Immigrants?
1
Gather the applicant's personal information.
2
List vaccination records chronologically.
3
Complete sections detailing any exemptions.
4
Check for completeness of information.
5
Submit the form to the designated authority.
Who needs the Vaccination Documentation Worksheet for U.S. Immigrants?
1
Immigrants applying for a U.S. visa need this form for vaccination documentation.
2
Panel physicians must complete this form as part of the immigration medical examination.
3
Refugees seeking resettlement in the U.S. require this for health compliance.
4
Individuals seeking a waiver for vaccination need to document their reasons here.
5
U.S. immigration authorities review this form to assess eligibility for entry.
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How do I edit the Vaccination Documentation Worksheet for U.S. Immigrants online?
You can easily edit the PDF on PrintFriendly by using our intuitive editing tools. Simply upload the document, make your changes, and save the new version. This streamlined process allows for quick updates to your paperwork.
1
Upload your PDF to PrintFriendly for editing.
2
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3
Review your edits for accuracy.
4
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5
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What are the instructions for submitting this form?
To submit this form, you can send it directly to the appropriate U.S. immigration office handling your visa application. If applying from outside the U.S., contact your nearest U.S. embassy or consulate for submission details. For any inquiries, you may reach out via email or telephone to the visa processing office to ensure timely handling of your application.
What are the important dates for this form in 2024 and 2025?
The current OMB Number for this form is 1405-0113, and it will expire on 09/30/2017. For new applications in 2024 and 2025, be aware of any updated forms or requirements as this information may change. Always check for the most current version of immigration forms before submission.

What is the purpose of this form?
The purpose of this form is to ensure that all immigrant visa applicants meet the U.S. vaccination requirements. It serves as an official record of an applicant's immunization history and any exemptions. Accurate submission of this form is critical for obtaining a visa and ensuring public health safety.

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

- 1. Applicant's Name: Full name of the visa applicant.
- 2. Birth Date: Applicant's birth date in mm-dd-yyyy format.
- 3. Vaccine History: Detailed record of administered vaccines.
- 4. Exemptions: Reasons for any vaccination exemptions.
- 5. Panel Physician Signature: Signature of the physician who completed this form.
What happens if I fail to submit this form?
Failing to submit this form can lead to significant delays in the processing of your immigration application. If your vaccination documentation is incomplete, it may result in denial of your visa. Always ensure that the form is fully completed and submitted on time.
- Visa Denial: Incomplete documentation may lead to your visa being denied.
- Processing Delays: Missing forms result in delays to your application process.
- Public Health Risks: Incomplete vaccination records could endanger public health efforts.
How do I know when to use this form?

- 1. Immigrant Visa Applications: Document vaccination status for visa applications.
- 2. Waivers for Vaccination: Request exemptions and provide documentation.
- 3. Medical Examinations: Part of the health assessment by panel physicians.
Frequently Asked Questions
What is the purpose of this form?
The form is used to document vaccination history for U.S. immigration applicants.
How do I fill out the vaccination history?
List vaccines chronologically along with the administering physician.
Can I edit this form online?
Yes, you can edit the form on PrintFriendly using our PDF editor.
What if I need a vaccination waiver?
Document your reasons in the exemption section of the form.
How do I save the completed form?
After editing, download the form directly to your device.
Is this form mandatory for immigrant visas?
Yes, it is required for all immigrant visa applicants.
Can I share the edited form?
Absolutely, generate a shareable link to send it directly.
Who should complete this form?
Panel physicians are responsible for completing this form.
How do I sign the document?
Use our signing tool to add your signature to the PDF.
What happens if I don't submit this form?
Failure to submit may delay or prevent visa processing.
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