Ungrouped

DO NOT COMPLETE THIS UNLESS YOU ARE REQUESTING RECORDS FROM DU'S WELLNESS CENTER
(.pdf, 98K)

Please use this form to take to your doctor to complete. When completed you can enter and upload this form to comply with Dominican's immunization requirements at Wellness Center Online.  Login with your Dominican Credentials, go to Immunizations and enter your required immunizations. Then upload an image of your document under the Upload tab.

(.pdf, 115K)