Immunization Form
Please complete the compliance form if records are available. Compliance forms can be printed and filled out by hand and faxed to 318-357-4660 or emailed to the admissions office using the email address of applications@nsula.edu. Please email or fax proof of immunization records from your Physician or Care Provider as well.
Please complete the waiver if records are not available, if taking all online classes only, etc. This form can be completed digitally and emailed to the admissions office using the email address of
applications@nsula.edu. Waivers can also be printed and filled out by hand and faxed to 318-357-4660.
Louisiana Law (R.S. 17:170.1 Schools of Higher Learning) requires all students entering Northwestern State University to be immunized for the following: Measles (2 doses), Mumps, Rubella—required for those born on or after January 1, 1957; Tetanus-Diphtheria (within the past 10 years); and against Meningococcal disease (Meningitis). The guidelines presented on the back of the “Proof of Immunization Compliance Form” are for the purpose of implementing the requirements of Louisiana R.S. 17:170.1, and of meeting the established recommendations for control of vaccine-preventable diseases as recommended by the American Academy of Pediatrics (AAP); the Advisory Committee on Immunization Practices to the United States Public Health Service (ACIP); and the American College Health Association (ACHA). Students not meeting the MMR & TD requirement will be prevented from registering for subsequent semesters.