Bacterial Meningitis

• Student's first and last name as it appears within their Magnus account.
• Student's date of birth (month/day/year)
• Health practitioner full name, signature or stamp
• Health practitioner must date (with a 4-digit year beginning in 2020) the document, or the document will be rejected.
• Healthcare professional must document whether this is a lifelong exemption or a specific timeframe exemption.

• Print coversheet and form from Magnus Health to be completed by health practitioner.
• Can be mailed, faxed, or uploaded to Magnus Health SMR by student through their myUHD portal

• Must be the Texas DSHS "Affidavit: Exemption from Immunizations for Reason of Conscience" Form
• Form must be notarized and submitted within 90 days of notarized date, or it is no longer valid and must be rejected.
• Meningococcal box on form must be checked.
• Students over age 18: Parent or Legal Guardian signature and date is not required. Student must sign and date this document.
• Students under age 18: Parent or Legal Guardian signature and date is required.
• Enter expiration date set for two years from date of notarization.

• Print coversheet from Magnus Health to be mailed with notarized Affidavit Form.
• ORIGINAL document and coversheet must be MAILED to:

Magnus Health, 514 Daniels Street #367, Raleigh, NC 27605

• No fax or uploaded affidavit for exemption from immunizations for reason of conscience will be accepted.

All entering students under the age of 22 enrolling in public, private, or independent institution of higher education on or after January 1, 2014. Any students under 22 years of age who previously attended an institution of higher education before January 1, 2014, and who are re-enrolling in any institution of higher education following a break of a least one fall or spring semester.

• An affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine in the United States, in which it is stated that, in the physician's opinion, the vaccination required would be injurious to the health and well-being of the student.
• If you are declining the vaccination for reason of conscience objection, including a religious belief, you must request the conscience affidavit exemption form from the Texas Department of State Health Services (TDSHS). Once requested, the affidavit form will be mailed from TDSHS to address submitted and then form must be completed and notarized.

• If you are only taking classes online, you are not required to take the vaccination. You will need to complete an “Online Classes Only Immunization Waiver" form. Please contact the Registrar's Office at UHDRecords@uhd.edu for additional information.
  
  
• If you are taking any face-to-face UHD courses at any site, you are required to satisfy the Bacterial Meningitis vaccination requirement if you fall within the law requirement.

You will not submit any forms to any UHD departments. After registering with Magnus Health SMR, you will submit your documents to Magnus Health SMR. You will do so by uploading your documents to your Magnus Health SMR account or by faxing or mailing your documents directly to Magnus Health SMR. Detailed instructions are provided once you log in to your Magnus Health SMR account.

If you have not been vaccinated within the past 5 years or 10 days prior to the first day of class you are enrolled at UHD, you may be able to receive a Bacterial Meningitis Immunization from the following:

Your health care provider, a local health clinic in your neighborhood, or your local pharmacy. UHD offers the immunization for UHD students only at the Student Health Services S445 for a cost of $117.

Please contact your local health care provider for a medical opinion.

The Meningitis vaccination recommended by the Centers for Disease Control and Prevention (MCV4 and MPSV4) offers protection for Meningitis groups A, C, Y and W-135. The MCV4 and MPSV4 are the only vaccines currently accepted. Please visit the CDC website for additional information.

A hold will be placed on your student record and you will not be able to register for classes until proper documentation is received.

Once you log onto myUHD, you will be able to attain access to your Magnus Health SMR account where you will receive immediate assistance. You can also call Magnus Support number 877-461-6831.