How to Fill Out and Submit the John Jay College Immunization Form

If you are enrolled at John Jay College of Criminal Justice in six or more credits, you must submit the John Jay College immunization form before you attend classes. The form is a two-part document: you complete your personal information and vaccination dates, a licensed healthcare provider verifies the vaccination history with an official stamp and signature, and you return the whole packet to the Wellness Center’s Health Services office by email, fax, or mail. The requirement applies to every student at that credit load, degree or non-degree.

What Goes on the Form

Download the current form from the John Jay Health Services page and work through it section by section. Missing a field or the provider’s stamp is the most common reason a submission gets bounced back.

Part 1: Your Information

Print your full name, date of birth, daytime phone number, and mailing address. Enter your eight-digit EMPL ID from CUNYfirst in the field provided. Health Services uses that number to match your form to your student record, so leaving it blank will stall processing.¹

Part 1A: Measles, Mumps, and Rubella

New York Public Health Law Section 2165 requires post-secondary students born on or after January 1, 1957 to prove immunity to measles, mumps, and rubella.² If you were born before that date, you are presumed immune and can skip this part. Everyone else proves it one of two ways.

Record the exact dates of two measles doses given after age twelve months and spaced at least 30 days apart, plus the dates of your mumps and rubella doses. If you received a combined MMR vaccine, the same dates cover all three.³
Or check the titer box and attach a copy of a lab report showing positive immunity to measles, mumps, and rubella. The report must show the actual test results and the lab’s name. A doctor’s note that says “immune” without the underlying data will not be accepted.²

Part 1B: Healthcare Provider Verification

Your doctor, nurse practitioner, or other licensed provider completes this section. They must print their name, address, license number, and phone number, then sign and apply their official office stamp.² A form without the stamp will be rejected. If you plan to have the form filled out at a pharmacy or urgent care clinic, call ahead to confirm they can provide an official stamp. Not every location has one.

Part 2: Meningococcal Meningitis Response

Public Health Law Section 2167 requires you to return a response form, but it gives you a choice.⁴ You can certify that you received a meningococcal vaccine within the past ten years and write in the date, or you can sign a statement that you reviewed the information about the disease and decided not to get vaccinated. Either way you must sign and date the form. Leaving it blank counts as noncompliance.

If You Can’t Find Your Old Vaccination Records

There is no national database of childhood vaccinations, so tracking down old records is on you.⁵ Check the obvious sources first:

Parents or family members who may have kept a childhood immunization card or baby book.
Your pediatrician or family doctor, though medical offices only retain records for a limited number of years.
Your high school, which collected immunization proof at enrollment but typically keeps records only one to two years after a student leaves.
Your state’s immunization registry. New York City residents can request records from the Citywide Immunization Registry through the NYC Department of Health. Elsewhere in New York, contact the State Department of Health or your county health department. For other states, the CDC maintains a directory of state immunization information system contacts.⁶⁷

If nothing turns up, you have two options. You can get revaccinated, which is medically safe even if you were vaccinated as a child, or you can have a doctor order titer blood tests to check for existing immunity. The titer route is often faster than scheduling multiple vaccine appointments, and the lab results satisfy the form on their own. Expect to pay roughly $95 to $110 out of pocket for an MMR titer panel if your insurance does not cover it.

If You Were Vaccinated Outside the United States

Foreign vaccination records must be translated into English before submission, and getting the translation is your responsibility.² Submitting untranslated documents will delay processing and can trigger a registration hold. If the foreign records are incomplete or use vaccine names that do not match U.S. standards, drawing titer tests at a U.S. lab is usually the cleanest fix.

How to Submit

Once the form is complete and stamped, Health Services accepts it three ways.⁸

Email: healthoffice@jjay.cuny.edu
Fax: 212-237-8026
Mail: Wellness Center: Health Services, 524 W. 59th Street, Room L68.00NB, New York, NY 10019

Email is the fastest option. Scan or photograph the completed form and every attached lab report as a single PDF or clear image, and name the file with your full name and EMPL ID so staff can match it to your record. If you mail a paper copy, use a tracked method; a form lost in transit means starting the process over. Allow at least three business days for review, and expect longer in the weeks leading into a new semester. Health Services will contact you directly if anything is missing.⁹

The Deadline and What a Hold Costs You

New York law bars colleges from letting a student attend classes beyond 30 days without complying with the immunization requirements. The MMR window under PBH 2165 can be extended to 45 days if you are from out of state or another country and can show a good faith effort to comply.¹⁰ The meningitis response window under PBH 2167 can be extended to 60 days on the same good-faith standard.⁴

Once the grace period expires, the college is required to exclude you from campus and from all classes.¹¹ In practice this shows up as a CUNYfirst hold that blocks registration. If exclusion happens after the tuition refund deadline, you lose what you paid, and any federal financial aid you had not yet earned through attendance may have to be returned under the Return of Title IV Funds rules.¹² The simplest way to avoid any of this is to submit the form before the semester starts rather than waiting for the clock to run.

Exemptions

Two exemptions exist from the MMR requirement. A medical exemption applies when a licensed physician or nurse practitioner certifies that the vaccine would be harmful to your health, and it lasts only as long as the contraindication exists. A religious exemption applies if you hold genuine and sincere religious beliefs that conflict with vaccination; the statute does not require an additional certificate.¹⁰ If you plan to claim either, contact the Wellness Center first to confirm what documentation they want to see.

There is no separate meningitis exemption, because the law already lets you decline the vaccine on the response form after reviewing the risk information. You still have to return a signed form; the decline is the exemption.

The Wellness Center is in Room L68.00NB of the New Building at 524 West 59th Street. You can reach it at 212-237-8111 or jjcwellness@jjay.cuny.edu with questions about any part of the process.¹³

1
City College of New York. FAQs – Health and Wellness
2
John Jay College of Criminal Justice. John Jay College Immunization Form
3
CUNY School of Law. Immunization Requirements
4
New York State Senate. New York Public Health Code 2167 – Immunization Against Meningococcal Meningitis
5
Centers for Disease Control and Prevention. Staying Up to Date with Your Vaccine Records
6
NYC Health. Vaccine Records
7
Centers for Disease Control and Prevention. Contacts for IIS Immunization Records
8
John Jay College of Criminal Justice. Immunization
9
John Jay College of Criminal Justice. Accepted Freshmen
10
New York State Senate. New York Public Health Code 2165 – Immunization of Certain Post-Secondary Students
11
New York State Department of Health. Section VII – Questions and Answers
12
Federal Student Aid. General Requirements for Withdrawals and the Return of Title IV Funds
13
John Jay College of Criminal Justice. Wellness Center