Measles Vaccine Requirement Form

Form Template

For many school campuses, college students must show evidence of measles immunity before arriving on campus.

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The immunity to measles rubeola is usually administered through the rubella MMR vaccine. Alternatively, students can provide results of a titer test which indicates immunity to the disease. With the Measles Vaccine Requirement Form app, students will submit proof of having received the two required doses of the MMR vaccine. The app includes options for age exemption or medical and non-medical exemptions. Medical exemptions require a physician's signature certifying exemption from the MMR vaccine based on a history of measles rubeola, a positive titer test that shows immunity to the disease, or another medical reason listed. For non-medical exemptions, students are required to complete one of two options in order to thoroughly understand the health risk of not being vaccinated. There are specific details for properly submitting all documentation.

Features
  • Signature Capture
  • Image Capture
  • Submission Editing
  • Reference Data
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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