Louisiana State law (Act 1047) requires that all persons who are entering Louisiana colleges and universities for the first time and whose date of birth is after 1956, must submit proof of immunization against preventable and/or communicable diseases, including measles, mumps, rubella, and tetanus-diphtheria (MMR, Td).

You may download and print the Acrobat Format of the Medical History form here.

(For the free Adobe Acrobat Reader ... )