Forms
- Immunization Form
- Consent to Release Immunization Records Form
- Request for Religious Exemption to Immunization Form
Submitting Forms & Retrieving Records
The following forms may be printed, completed, and submitted to Immunization Records, Room 307, North Building. For more information about immunization requirements and documentation, please visit our Immunization Requirements page.
Do you need a copy of your immunization records for your personal records or would you like them to be sent to another institution? Immunization Records can release your immunization records in one of the following ways:
- You can pick up your records in person at Immunization Records, Room 307, North Building (a valid photo ID is required)
- Or you can fax, email or mail the Consent to Release Immunization Form. If you are e-mailing the form, it must be scanned in a PDF format and you must attach a valid and legible photocopy of your ID. No mobile snapshots of IDs will be accepted.
Any student whose religious belief prohibits vaccination must complete the CUNY Religious Exemption Form. Exempted students will not be permitted on campus during a communicable disease outbreak.
* When downloading forms, (Adobe Acrobat Reader) is required.