Health Forms
- Health History and Physical Examination Form (PDF) (opens in a new tab)
- Authorization for Release or to Obtain Medical Records (PDF) (opens in a new tab)
Meningococcal Meningitis Information
The following form and resources provide information about meningococcal disease, vaccination, and New York State Public Health Law 2167.
Meningococcal Vaccination Response Form
Meningococcal Vaccination Response Form (PDF) (opens in a new tab)
Meningococcal Disease and Vaccine Resources
- Meningococcal Disease Information – New York State Department of Health (opens in a new tab)
- Meningococcal ACWY Vaccine Information Statement (PDF) – CDC (opens in a new tab)
- Meningococcal Vaccine Recommendations – CDC (opens in a new tab)
- Meningococcal Disease: Questions and Answers (PDF) (opens in a new tab)
- National Meningitis Association (opens in a new tab)
Using Fillable PDF Forms
Download the form to your computer and open it with a PDF reader. Complete all required fields and add a digital signature where required. Once the form is complete, save the completed PDF to your computer and submit it to the Wellness Center.
