How to Fill Out and Submit FAMU’s Health History and Immunization Form

To clear the immunization hold that blocks class registration at Florida A&M University, you need to complete the FAMU Health History and Immunization Form, have a licensed healthcare provider document your required vaccines on it, and submit it directly to Student Health Services. The form is a downloadable PDF on the Student Health Services immunizations page, and until that office accepts your paperwork, you cannot register for courses or request transcripts.1Florida Agricultural and Mechanical University. Student Holds2Florida Agricultural and Mechanical University. Immunizations and Requirements

What the Form Has to Document

FAMU requires proof of three vaccinations before it will clear you to register:

  • Measles, Mumps, and Rubella (MMR): two doses of a live measles-containing vaccine. The CDC requires post-secondary students born in 1957 or later to show two doses given at least 28 days apart, or lab evidence of immunity.3Centers for Disease Control and Prevention. Measles Vaccine Recommendations for Non-Pregnant Adults
  • Hepatitis B: proof of the completed vaccination series, or a signed waiver declining the vaccine.
  • Meningococcal meningitis: proof of vaccination, or a signed waiver declining the vaccine.

Florida law requires anyone living in on-campus housing to provide vaccination documentation for Hepatitis B and meningitis unless they sign a separate waiver for each one. If you are 18 or older, you sign the waiver yourself; if you are a minor, a parent signs. The FAMU form has a declination section for this purpose.4Online Sunshine. Florida Statutes 1006.69 – Vaccination Against Meningococcal Meningitis and Hepatitis B

International students and students arriving from countries the World Health Organization classifies as having a high incidence of tuberculosis also need a TB skin test or blood test performed within 12 months before the first day of classes. A positive result does not disqualify you, but you will need to attach a chest X-ray report and any treatment documentation. Student Health Services can confirm whether your country of origin triggers this requirement.2Florida Agricultural and Mechanical University. Immunizations and Requirements

Filling Out the Form

Download the current PDF from the Student Health Services immunization page. The version linked on the site is the 2024 form.5Florida Agricultural and Mechanical University. FAMU Health History and Immunization Form You complete two parts yourself and a healthcare provider completes the third.

Your Sections

Fill in your full legal name, date of birth, and FAMU student ID number at the top. Get the ID number right, because that is how Student Health Services links your medical record to your academic account. Work through the health history questionnaire honestly: past medical conditions, surgeries, allergies, and current medications. The information stays with Student Health Services and is protected under medical records confidentiality rules. You do not need a separate comprehensive physical exam to enroll, only the health history and the immunization documentation.5Florida Agricultural and Mechanical University. FAMU Health History and Immunization Form

The Provider Section

Take the form to a licensed healthcare provider: your primary care doctor, a clinic, or a local health department office. The provider enters the dates of each vaccine dose. For the form to count as official, this section must carry both a signature from the authorizing person and an office stamp. Forms missing either will not be accepted, and this is where most rejections happen.5Florida Agricultural and Mechanical University. FAMU Health History and Immunization Form

A few additional rules from the form itself:

  • The provider should mark out any blank spaces in the immunization fields after signing. Shots added later must go on a separate attached sheet with a new signature, date, and office stamp.
  • Any changes, write-overs, use of different ink or handwriting, or use of white-out must be re-signed by the authorizing person.
  • You may attach copies of official immunization records such as a state registry printout, but each attached document must show your name on the front page.

Cross-check the dates your provider enters against your own records before you leave the office. A mismatch between the form and your state immunization registry can delay approval, and Student Health Services reserves the right to question the validity of any document.

Religious and Medical Exemptions

FAMU recognizes two exemption paths, both of which require more paperwork than simply leaving the immunization section blank.2Florida Agricultural and Mechanical University. Immunizations and Requirements

For a religious exemption, provide a signed statement from your church or a personal written statement describing your religious belief, along with a completed FAMU vaccine waiver signed by you or your guardian.

For a medical exemption, a physician must provide written documentation on office letterhead explaining the specific medical reason vaccination is contraindicated. You or your guardian must also complete the FAMU vaccine waiver. Temporary deferments are available for documented pregnancy, breastfeeding, or current illness, also on office letterhead.

An approved exemption does not drop the hold automatically. Student Health Services still has to review and accept the exemption paperwork before your account is cleared.

Where to Submit It

Send the completed form directly to Student Health Services, not to the Admissions Office or any other department. Sending it to the wrong office is a common cause of delay.2Florida Agricultural and Mechanical University. Immunizations and Requirements You have two submission options:

  • In person: bring the form to Student Health Services on the first floor of the FAMU Center for Access and Student Success (CASS) Building. Office hours are Monday through Thursday, 8:00 a.m. to 4:30 p.m., and Friday, 10:00 a.m. to 4:30 p.m. Hours may change during breaks and holidays.6Florida Agricultural and Mechanical University. FAMU Student Health Services
  • Fax: send to (850) 599-3067.6Florida Agricultural and Mechanical University. FAMU Student Health Services

To confirm receipt or ask a question, call the immunizations line at (850) 599-3779. Keep a personal copy of everything you submit, including a fax confirmation page if you fax it.6Florida Agricultural and Mechanical University. FAMU Student Health Services

After You Submit

Staff review your form against state and university requirements, and the immunization hold stays on your account until they verify everything. You can check the hold’s status through the university’s student account system.1Florida Agricultural and Mechanical University. Student Holds If the hold is still there after you have submitted, call Student Health Services. The usual culprit is a missing stamp, an illegible date, or an incomplete waiver section.

Clearing the hold matters for housing too. The university housing agreement states that failure to submit required vaccination records results in cancellation of the housing agreement, and the non-refundable advance payment is not returned. For new students, that payment is $200.7Florida Agricultural and Mechanical University. Student Housing Agreement Terms, Conditions, and Responsibilities

Processing takes longer during peak enrollment, particularly the weeks before fall orientation, so submit well ahead of your intended registration date. If you discover after submission that you need additional vaccines, have your provider document the new doses on a separate sheet with a fresh signature, date, and office stamp, and send that supplement through the same channel you used the first time.