For all teams going on outreach.


Outreach Immunization Information

It is the responsibility of the designated outreach staff member to fill out the following form for EACH and EVERY staff member and student going on outreach.

If you have ten students and one staff plus your self going on outreach, that means you need to fill this form out twelve times.

Once you start filling out the form, it needs to be done in ‘one hit’, you can not return to a form at a later date, and you can only submit a form if ALL the required fields have been filled out.