UMD: A Globally Connected University

Immunization Form Instructions

Immunization Form Instructions

Questions about any immunization requirements should be addressed to the Health Center Immunization Office.  The Immunization Form is available here and must be completed in English.

The Immunization Form is available here and must be completed in English.

Step 1: Complete Top
Complete the personal information in the section at the top of the form (your name, UID number, date of birth, etc.). 

Step 2: Immunization for Measles, Mumps and Rubella (MMR) – Section A
The University of Maryland at College Park requires ALL incoming students to provide completed proof of immunization dates for Measles, Mumps and Rubella (M.M.R., 2 doses), and Tdap/TD within the past 10 years. A copy of a lab titer for Measles, Mumps and Rubella will be accepted in lieu of the immunization dates.

Step 3: Meningococcal (Meningitis) – Section B/C
Required if you will be living in on-campus student housing. Alternately, you can sign a waiver opposing the vaccine (Section C).

Step 4: Tuberculosis (TB) Testing Questionnaire – Section D
Every student must complete this section. If you have answered yes to any of the questions, the Quantiferon Gold or T-spot must be done. This will be only accepted if done in the US.

Step 5: Optional Recommended Immunizations – Section E
Other recommended immunizations for all incoming students are: Chicken Pox (Varivax; 2 doses); Hepatitis A (2 doses); Hepatitis B or Twinrix (3 doses); HPV (3 doses); Influenza (yearly). They are not required for students at the University of Maryland. These immunizations can be acquired through the University Health Center, if desired, at a later date and by appointment.

Step 6: Option Gender Identity - Section F
This section is optional, for students that want to more specifically list their gender identity.

Step 7: Submission of Completed Documents
Immunization forms must be submitted to the University Health Center before orientation. Forms may be uploaded to You will be prompted for a Directory ID and Password, then you will enter your UID number.  Go to forms, select Immunizations, and enter all the appropriate requested immunization dates found on your records.  Click on Add Immunization Record - where you will scan your document to the record.  Then Submit Final.

University Health Center
University of Maryland
College Park, Maryland 20742