Tulane Immunization Compliance Form

Purpose of the Form

The Tulane Immunization Form documents that the student has received the following:

  • Measles, mumps, rubella vaccine (MMR)
  • Tetanus vaccine (Tdap preferred)
  • Meningococcal ACWY vaccine

The student's health care provider will complete and sign the form. Completed signed forms must be uploaded to the Patient Portal. Faxes and emails are not accepted. 

The form serves as a guideline for students to gather all immunization records in one step. However, using the form is not mandatory. As an alternative to using this form, you can submit proof of these vaccinations from your external healthcare provider by uploading them to the Patient Portal.

Choose Your Form

Find the form below that is applicable to you.

Standard immunization forms for Tulane students

Special immunization form for School of Medicine students

Vaccine waiver forms

Students who are opting out of any of the required vaccines for medical, religious or personal reasons must submit a waiver form online via the Patient Portal. For each required vaccine a student wishes to opt out of, a separate waiver form submission is required. These waiver forms can be found by logging on to the Patient Portal, clicking on the Forms tab and scrolling down to the Immunization Waivers section.

Please note that students who opt out of new immunizations are still required to submit records of any immunizations they have received in the past.

Instructions to Complete and Submit

NOTE: You must have received your Tulane Login Information (email address) and Student ID prior to completing and submitting the Immunization Compliance Form. (Note: It takes approximately 24-48 hours for the Tulane system to link with the Patient Portal system. So if your information is not found, please check back in a day or two.)

Gather Information

  1. Print your immunization form and complete the top section. Take it to your health care provider.
  2. Have your health care provider complete the rest of the immunization form, sign it, and place an official stamp next to the provider signature. Make sure the health provider provides copies of lab reports, if applicable.

Enter and Upload Information Online

  1. Scan the complete and signed form and any other supporting documents (clear and readable photos of documents are acceptable). The file size must be smaller than 4 MB.
  2. Log into the Tulane Campus Health Patient Portal using your Tulane email address (without the @tulane.edu) and your email password.
  3. Click Immunization in the top menu.
  4. Click Enter Dates.
  5. Fill in all the dates and information copied directly from your Immunization Compliance Form. When finished, click Submit.
  6. After you enter dates, upload your scanned document using the Upload Documents link.
  7. After your form is uploaded, it may take up to five business days for the form to be reviewed and verified. Check your Tulane email regularly for notification of secure messages from the Health Center.
  8. You will receive a secure message via the Patient Portal notifying you whether your records are either (a) in compliance which allows you to register for classes or (b) out of compliance which means you cannot register for classes until you upload the additional records specified via secure message.