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Immunization History Form and Instructions

One of the required steps in completing your Conditional Admission is the submission of the Immunization History Form. This form, along with the instructions, can be found below. Please copy the form and take it to a primary care physician for completion, and then return it to the College of Pharmacy by the date specified in acceptance documents. Don't forget to keep a copy for your records.

Here is our address:

College of Pharmacy
Office of Enrollment and Student Services
1400 N. Roosevelt Blvd.
Schaumburg, IL 60173

If you have any questions about the Immunization History Form or the instructions, please either email us at cop@roosevelt.edu, or call the Office of Enrollment and Student Services at 847-330-4500.



IMMUNIZATION HISTORY FORM INSTRUCTIONS

IMMUNIZATION HISTORY FORM