Shadowing Immunization & Testing Requirements

Once the preceptor submits a shadow visitor request, the shadow visitor will receive an automated email regarding immunization/testing verification.

Choose one option:

• Option 1: Your Primary Care Provider can complete the Physician Verification Form.

  • This form cannot be completed by a relative.

  • Information cannot be added after the form is signed.

  • All information must be in English
• Option 2: Provide a copy of your immunization records with the required vaccinations circled or highlighted. Ensure your records include all required vaccinations and TB testing results (see the TB testing section below for more information).

**All documents must be in English or translated by a Certified Medical Translator.  Anything else is not considered official medical documentation.

Contact your primary care provider, local health department, or college/university campus health to determine if they can complete the Physician Verification Form or provide a copy of your medical records. If vaccination proof cannot be located your health provider can either:

• Readminister the vaccine(s).
• Order a titer blood test to determine immunity.
  • If the titer report does not indicate immunity, the vaccine must be administered to meet onboarding requirements.

Please check with your insurance provider or entity completing your vaccination administration/testing as there may associated costs and reimbursement is not provided

Tuberculosis (TB) Screening is a way to determine an individual's status of active TB or latent TB infection. Testing must have occurred within the past 12-months. Please watch this TB Testing Instructional Video to ensure the steps are followed correctly.

Choose one option:

• Option 1: Two (2) TB Skin Tests
  • A Tuberculin Skin Test (TST) is performed by injecting a small amount of fluid into the skin.
  • Takes about 2 weeks and 4 separate visits.
  • The 2nd TB skin test should be placed at least one week after the 1st test was read/checked. If placed earlier, it will not be accepted and a 3rd test must be completed. See example timeline below.

    Visit 1, Day 1	Visit 2, Day 3 (or 48-72 hours after 1st test placed)	Wait at least one week	Visit 3, Day 10	Visit 4, Day 12 (or 48-72 hours after 2nd test placed)
    First TST placed	First TST read/checked		Second TST placed	Second TST read/checked

• Option 2: TB Blood Test (IGRA- T-Spot or Quantiferon Gold).
  • A TB blood test is performed by drawing blood and sending it to a lab for testing.
  • Takes up to 5 days and 1 visit.

• Refer to the Immunization Requirements Checklist if you have completed Two-Step TB skin testing previously or have history of positive TB.

Choose one (1) option below:

1. Vaccine: Provide official documentation of 2 MMR vaccines at least 1 month apart given after age 1 or HCP must provide documentation of individual vaccines totaling 2 Measles, 2 Mumps, and 1 Rubella vaccinations.
2. Titer: Provide official documentation of positive laboratory titers.

Choose one (1) option below:

1. Vaccine: Provide official documentation of 2 Varicella (chicken pox) vaccines or 1 Zostavax vaccine (shingles).
2. Titer: Provide official documentation of positive laboratory titer.

Provide vaccine record of one Tdap as an adult or adolescent (≥ 11 years of age).

Not mandated but is recommended.

Provide documentation including dates, manufacturers and locations received, as well as any boosters.

Documentation of a current flu vaccine is only required if it is currently flu season (September - April/May). If you are applying outside of these dates, you do not need to provide flu vaccine documentation. Medical and/or religious exemptions are not accepted for shadow visits.