VACCINATE BEFORE YOU GRADUATE

All students attending state colleges or universities in Ohio and living in on-campus housing are required to sign a form stating whether or not they have received the meningitis vaccine.

MENACTRA – the meningitis vaccine – will be offered to high school seniors at a “Vaccinate Before You Graduate” clinic sponsored by Kent State University Health Services.

Also offered this year, GARDASIL, the vaccine that helps protect against Human Papillomavirus (HPV) types 6, 11, 16, and 18. Gardasil is a series of 3 injections for girls and women 9 through 26 years of age. Students receiving their first dose of Gardasil at the clinic will be given information to assist them in receiving the second and third dose via their own primary care provider.

KENT ROOSEVELT CLINIC

WHEN: Tuesday, May 13th
10am – 1pm

WHERE: Room 514 (Health Technology classroom)

COST: Menactra (meningitis) $105.00
Gardasil (HPV) $150.00

BILLING:
Some insurances will reimburse for one or both vaccines. Please contact your individual health insurance provider to determine if this immunization is covered by your policy. Students will be given a receipt to submit for reimbursement.

PRE-PAYMENT FORM: You may choose to pre-pay for your student by downloading the pre-payment form and submitting it to: VBYG
c/o Kent State University Health Services
P.O. Box 5190
Kent, OH 44242

Although pre-payment is the preferred method to ensure adequate supplies and staffing, WALK-INS are welcome. Please make checks payable to: KSU Health Services.

CONSENT FOR MINORS: Parents of students who will not be 18 years of age at the time of the clinic are required to read and sign the consent for minors form.

QUESTIONS: Please contact Shelly Verba at sverba@kent.edu or (330)672-8231

In the event that your student has pre-paid and is unable to attend the clinic, please call the above number and an appt. will be scheduled for your student at University Health Services.

CONSENT FORM