Immunization Forms

All current immunization forms and forms for Student Health can be found at

This includes the Immunization Record Form and the Consent to Release Records FROM Mason Form (to obtain immunization records from Student Health)


Immunization Office is closed Monday Oct.2


Immunization records due by Oct 1st.

All new incoming summer/fall students must submit immunization records by the deadline. Records turned in after the deadline or records that are incomplete after the deadline will be charged a late fee and a hold will be placed on the student's account.

Walk-in or Email

The Immunization Office will be unable to take phone calls during this time.  Please email (response within 48-72 hours) or stop by the office regarding immunizations. Phone lines will reopen October 9, 2017.

Past Due Immunization Records

If you have a hold and late fee, you must complete the immunizations and pay the late fee to Student Health Services to have your hold removed. The hold will be released usually by the end of that business day, if after 4:30 pm it will be processed the next business day.


Note: Do not include social security numbers on your immunization records.

Immunization Office

Hours: Monday - Thursday: 8:30- 4:30 pm, Friday: 12:30 - 4:30 pm

Phone: 703-993-2135


Address: Student Union Building I (SUB I), Rooms 2347 & 2348

4400 University Drive, MS 2D3, Fairfax VA 22030

FAX: 703-993-4053

Immunization Forms

Immunization Fees