Students in front of the University Health Center, University of Georgia


The following Certificate of Immunization and TB Screening Form must be printed, completed, signed by your doctor, and returned to the health center before you can register for classes. Please keep a copy for your records.

Certificate of Immunization
Tuberculosis (TB) Screening Form

In addition, please complete and return the following inssurance form if applicable:

University Health Center Medical Insurance Form

(These forms are in PDF format. You must have Adobe Reader 6.0 in order to view and print. Download Adobe Reader)

Mail to:
Patient Registration and Health Information
University Health Center
Athens, GA 30602-1755

Fax number:


Visit the Health Information page for information on transferring immunization records.

Requirements and Recommendations

Listed below are the immunization requirements for students entering the University. Please review the chart below for additional recommended vaccines. All required vaccines are available at the University Health Center Allergy/Travel Clinic.

Questions about immunization requirements? Call Patient Registration and Health Information at 706-542-8617.

Required Immunizations:
(Measles, Mumps, Rubella)
Students born in 1957 or later. Two doses or titers with results attached are required. First does of MMR must be done after the first birth date. Second dose 30 days later. Students born before 1957 need to show proof of Rubella.
(Chicken Pox)
Students born in 1980 or later. All foreign born students regardless of year born. Two doses, date of disease, or titer with results attached are required. If first shot given before 13th birthday, the second shot must be given 3 months later. If first shot given after 13th birthday, second shot must be given 30 days later.
Tetanus/Diptheria (Tdap) All students. Vaccine must be within last 10 years.
Hepatitis B Students 18 years old or younger. 3 doses. Second dose given 1-2 months after the first shot, and the third shot given 4-6 months after the first dose.
(Tuberculosis screening)
All students. Students must complete the "Tuberculosis (TB) Screening Questionnaire (Required), page 2 of the immunization form, and return this to the University Health Center. All students with any risk noted on the "Tuberculosis (TB) Screening Questionnaire" must also complete page 3 of the immunization form, "Tuberculosis (TB) Risk Assessment," and return this to the University Health Center.
Recommended Immunizations:
Hepatitis A 2 doses.
(Human Papillomavirus)
Recommended for males and females through age 26.
Influenza Flu shots are recommended at start of influenza season (October – March).
(Meningococcal disease)
Signed documentation required from newly admitted freshmen or matriculated students planning to reside in university housing indicating that they have received the vaccine or have reviewed information about the disease.
The Advisory Committee on Immunization Practices (ACIP) updated their meningococcal disease immunization recommendations in June 2009. They recommend college freshmen living in dormitories to be vaccinated with quadrivalent conjugate vaccine MCV4 (trade name "Menactra") within the preceding four years. Those individuals who have not been vaccinated with Menactra within this time frame should be revaccinated with Menactra to improve protection against meningococcal disease.