Returning Student Immunization Status Request

Please complete the information below to request verification that you have immunization records on file with the university that are current and meet the State of Illinois Immunization Requirements for College Attendance. Response will be sent to your Lewis University email address within 2 business days.

*Student Last Name:


*Student First Name:


Previous Last Name if applicable:


*University ID Number:


*Lewis University Email:


*Birth Date:


*Last Semester Attended Lewis University
Semester 
Fall
Spring

Year
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