KSU Certificate of Immunization Form

Students may use this form to have their physician report their immunization record. Non-US Citizens should also have their physician complete the Tuberculosis Screening on Page 3 of the form.

KSU Certificate of Immunization Form

Release of Immunization Records Form

You can request a copy of your immunization record on file at KSU by clicking on the appropriate button below. If you are currently enrolled at KSU, please use the Current Student Immunization Release Form button. If you have not attended KSU the past three semesters, please use the
Past Students/Alumni Immunization Release Form button.

Current Student Immunization Release Form

Past Student/Alumni Immunization Release Form

Immunization Exemption Form

This form may exempt you from the immunization requirements if you have religious objections or cannot be immunized due to medical reasons.


Meningitis Statement Form

You will need to submit this form prior to moving into KSU on-campus housing.

Meningitis Statement Form

Office Location/Hours

Office of the Registrar
Kennesaw Hall

Mail or Hand Deliver Documents

Office of the Registrar
585 Cobb Avenue NW
Room 1533, MD 0116
Kennesaw, GA 30144

Monday through Friday
8:30 a.m. - 4:30 p.m.

Please allow 3-5 business days for processing.