Texas Students: How to obtain a blank form to valid proof of the Meningitis vaccine

Last Updated: Feb 16, 2015 01:52PM EST
As a convenience, we make a Bacterial Meningitis Immunization or Exemption form available to students in their Magnus Health account.

Option 1

Proof of Vaccination: To obtain a blank form 
Step 1) From the Front Desk, click on the "Click Here" button and access the requirements page.
Step 2) Next to your 1 requirement you will see "Click here". Your next question will be, "Have you already obtained one of these 3 documents?"
Step 3) If you need a blank form click "No, Click for instructions to get started". This will allow you to download and print the blank form.  

Students who have not been vaccinated, can take this form to their provider. Have them fill out the form completely. If the student has been vaccinated but was not given proof of vaccination, the student may take the form back to the provider and have them fill out the form completely. Please have the healthcare professional to fully complete the following sections.

1. Fill in the first and last name, as well as the students date of birth.
2. Check which vaccine the student has been vaccinated for.
3. Place the administration date on the vaccine administered line that has been provided.



4. Make sure that the physician or personnel that provided the vaccine date, print their name, sign OR stamp the student's form.


 
Tip: Uploading your records is the quickest way to submit them to your account. If you submit your documents by fax or mail, it will take one to two business days after they are received to process them, and load them to a student's account. To learn more click here
  
Option 2

If you are going to submit your own documentation it will need to abide by the guidelines listed below:

1. Shot Record or Immunization Record
  • This document should have a signature or stamp of the physician, a designee, or the public health personnel who administered the immunization
  • The document can be generated by a state or local health authority or from another school, including those from another state.
2. Medical Exemption
  • This is a document or certificate signed by a physician. The Medical Exemption must state the physician's opinion that the vaccination would be injurious to the health and well-being of the student.
Tip: Uploading your records is the quickest way to submit them to your account. If you submit your documents by fax or mail, it will take one to two business days after they are received to process them, and load them to a student's account. To learn more click here

3. Conscientious Objection Exemption/Affidavit
  • This document is signed by the student stating that the student declines the vaccination for bacterial meningitis for reasons of conscience, including a religious belief. Have the form notarized by a notary public (fees may apply).
Tip:  Affidavits from the state health department can only be mailed in for submission. It will take one to two business days after they are received to process them, and load into a student's account. To learn more about your fax or mail cover sheet click here