Immunization Late Fee Appeal Form

Immunization Record Late Fee Appeal

Appeal form for Spring 2022 semester only.

If you believe there are extenuating circumstances that prevented you from submitting completed immunization records on-time, you may submit an appeal using the online form only for the Immunization Late Fee once all of your immunization records are completed and submitted. Appeals will be automatically denied if you are not in compliance. Check compliance status in the patient portal. Appeals will not be accepted via email. For late fees placed in fall, the appeal submission deadline is September 15th of the same semester. For late fees placed in spring, the appeal submission deadline is March 19th of the same semester. Appeals will not be considered for prior semesters.

Please explain your reasons for requesting an appeal of the immunization record late fee. Allow at least 10 business days after submission for review of your appeal request. Student Health Services may request additional information regarding your appeal.

Submission deadline for prior semester has passed.

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