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Xavier University First day of class Documents: Immunization Certificate Immunization Dates: Meningococcal (1 dose @ age 16 or older) Hepatitis B (3 doses OR Pos. Quant. Titer) MMR (2 doses OR Pos. Titer) Immunization Dates: Meningococcal B Two-Step Tb Results Varicella Polio Hepatitis A TDaP Booster HPV Immunization Dates: JE - Japanese Encephalitis Typhoid Yellow Fever Rabies Copyright © 2018 by MedProctor, LLC.

Xavier University First day of class Documents ... › health-wellness › health › ... · 2nd 3rd Optional Yellow Fever One Optional T hoid - Inactivated One Optional MENINGOCOCCAL

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Page 1: Xavier University First day of class Documents ... › health-wellness › health › ... · 2nd 3rd Optional Yellow Fever One Optional T hoid - Inactivated One Optional MENINGOCOCCAL

Xavier University

First day of class

Documents:Immunization Certificate

Immunization Dates:Meningococcal (1 dose @ age 16 or older)Hepatitis B (3 doses OR Pos. Quant. Titer)MMR (2 doses OR Pos. Titer)

Immunization Dates:Meningococcal BTwo-Step Tb ResultsVaricellaPolioHepatitis ATDaP BoosterHPV

Immunization Dates:JE - Japanese EncephalitisTyphoidYellow FeverRabies

Copyright © 2018 by MedProctor, LLC.

Page 2: Xavier University First day of class Documents ... › health-wellness › health › ... · 2nd 3rd Optional Yellow Fever One Optional T hoid - Inactivated One Optional MENINGOCOCCAL

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Xavier University

PRINT CLEARLY WITH DARK BLACK INK.This form will be read by a computer.

Copyright © 2018 by MedProctor, LLC.