Minnesota Law (M.S. 135A.14) requires proof that all students born after December 1956 are vaccinated against diphtheria, tetanus, measles, mumps, and rubella, allowing for certain specified exemptions (see below). UMD is required to collect and maintain these records. The MN Dept of Health and local health board are authorized by state law to inspect this information. All information on this form, except your name, is private data. This law allows for some exceptions (see age-Part 1, medical-Part 3, or conscientious exemption-Part 4).
Note: To avoid any registration delays or holds, please return this form within 45 days after first enrollment.
Use this form if...
- You were born after December 1956
Don't use this form if...
- You graduated from a Minnesota high school since 1997, you are exempt from these requirements (because they will already have been met)