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 Mailing Address:
  Student Health Services
  200 Hudson Health Center
  Memphis, TN 38152


 Phone #:
  (901) 678-2287




 

 


Forms > Certificate of Immunization

 

TENNESSEE STATE LAW requires all entering college students to have up-to-date immunizations or immunity against measles, mumps, and rubella. This record must be completed before registration and reflect proof of 2 MMR vaccinations administered on or after your first birthday, or documented proof of immunity to measles.

Contraindications to receiving the vaccines may include pregnancy, allergy to a vaccine component, other valid medical conditions, or religious tenets prohibiting vaccinations. If you believe that you are entitled to an exemption based on one of the preceding grounds, you must contact Student Health Services at The University of Memphis prior to registration. If an exempted student contracts measles or if a measles outbreak occurs it shall be the student's personal responsibility to remain off campus until a physician gives written permission for the student to return to campus.

Documentation is to be brought, faxed, or mailed to Student Health Services. Acceptable documents are: official immunization cards or documents from Public Health Departments, DD214 military forms, official documentation from prior universities, or this form signed by your doctor. Photocopies are acceptable, as originals will not be returned.

Please disregard this form if you were born before 1957, if you are attending part-time, or if you graduated from a Tennessee public high school in 1999 or thereafter. YOU WILL NOT BE ALLOWED TO REGISTER FOR CLASSES UNTIL ADEQUATE DOCUMENTATION OF IMMUNIZATION IS ON FILE AT STUDENT HEALTH SERVICES. We encourage you to get any "missing" immunizations prior to arrival on campus.


CERTIFICATE OF IMMUNIZATION FORM

 

 

 

 

 

 

 

 

 

 

 

 

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Site was last updated on September 4, 2008
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