Summary: INSTRUCTIONS FOR COMPLETING THE REQUIRED IMMUNIZATION FORMS
Please attach Immunization and TB forms to the application as they are part of the application process and are due at
the same time as the application. Current UGA students do not need to complete immunization form.
Address: University of Georgia FAX: 706-542-4270
Studies Abroad - Cortona
270 River Road
Athens, GA 30602-7676
Certificate of Immunization Required (page 1)
A. It is the policy of the University Health Center to comply with the mandatory immunization program
established by the Board of Regents of the University System of Georgia. These requirements include
documented proof of immunity to measles, mumps, and rubella, varicella (chicken pox), tetanus, and hepatitis
B, prior to registration at any college or university within the University System. No temporary clearances are
given to allow registration without meeting these requirements. Please note that dates of immunizations and
titers with results are required. The physician or other healthcare provider must sign the form. Any request
for consideration of exemption must have signed documentation attached.
Tuberculosis (TB) Screening Questionnaire Required (page 2)
A. Complete the form, answering the four questions, signing and dating. If you answer "NO" to all 4 questions,
you do NOT need to turn in the "Tuberculosis (TB) Risk Assessment (page 3)
B. If you answer "yes" to ANY of the 4 questions, then you need to take the "Tuberculosis (TB) Risk Assessment -
Required if risk noted on TB Screening Questionnaire" to your healthcare provider to fill out, sign and date.