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You have submitted an HSIP form that was submitted&nbsp;incompletely. Please review the submitted form and fully complete it, then resubmit it for approval.&nbsp;&nbsp;
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If you have questions, please contact HSIP at <a rel="noopener noreferrer" class="Hyperlink SCXW59686940 BCX0" target="_blank">myshots@uw.edu</a>. &nbsp;
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You have submitted an HSIP form that was submitted incompletely. Please review the submitted form and fully complete it, then resubmit it for approval.  

If you have questions, please contact HSIP at .  

UW HSIP- Rejected HSIP Form Incomplete

Is Med+Proctor Affiliated With My University?

Am I Required to Use Med+Proctor?

What if I Do Not Want to Use Med+Proctor?

Does Med+Proctor Have a Phone Line?

How to Contact Med+Proctor

Does Med+Proctor Integrate Data With Colleague, Banner, eClinicalWorks, etc.?

"Personal Information Missing" 

"Referred to Institution" What Does This Tag Mean?

"Online Exemption request" What Does This Tag Mean?

"FLShots data added" What Does This Tag Mean?

Complete Insurance Billing Page

UW – Missing Provider Signature 

UW – Incomplete or Blank Form 

UW – Missing Dates

UW – Missing Identification

UW – Password Protected 

 UW – Illegible

UW – MyChart Screenshot No Name

UW – Needs MenACWY

UW – Needs MenACWY (MenACWY Under 16)

UW – Needs MenACWY (Received MenB)

UW – Needs 1 MMR

UW – Needs 1 MMR (Measles/Mumps Under 1)  

UW – Needs 2 MMR

UW – Needs 1 Measles

UW – Needs 2 Measles 

UW – Needs 1 Mumps

UW – Needs 2 Mumps

UW – Military Documentation Provided

UW – No Requirements

UW – Measles Exempt   

UW – Mumps Exempt  

UW – Meningitis ACWY Exempt  

UW – Referred to Institution

UW - Needs MenACWY (Unaccepted Vaccine)

UW - Needs 2 MMR (Neg or Equiv Titers)

UW - Needs 1 MMR (MMRs Too Close)

UW - Document Error

Men B Not Accepted

Missing UCF health history form

Conscience Exemption

Meningitis A/C/W/Y Waived

AU- Chest x-ray not accepted

AU- Positive TB test

Missing UH TB Screening

Missing PBA Exemption Form

Insurance Form (Part B) Missing

UW - Needs 2 MMR (MMR Under 1)

UW - Needs 1 Measles (MMR Under 1) 

UW - Needs 1 Mumps (MMR Under 1)

Tarleton Conscience Exemption

UH-TB Confirmation By US Practitioner

Medical Exemption Request

Religious Exemption Request

Need TDAP vaccine from age 10 or older

Missing TDAP from age 10 or after

Missing Meningitis Vaccine Date

DEXT3

DEXT1

TB Outside of the US Not Accepted

NEIU- TDAP Expired

Not Required, Age Exempt- 22 Or Older

Missing Date Polio #1

Missing Date Polio #2

Missing Date Polio #3

Missing date Polio #4

Missing ULV TB Screening Form

Missing ULV Health History Form

Contact ULV Health Center

Missing QuantiFERON Gold in the US 

UW HSIP - Required Hepatitis B

UW HSIP - Required TB Risk Assessment 

UW HSIP - Required MMR

UW HSIP - Required Varicella  

UW HSIP - Required Tdap  

UW HSIP - Required Tuberculosis Screen

UW HSIP - Required Influenza Vaccine  

UW HSIP- Rejected Document Type  

UW HSIP- Rejected Unverifiable Dose(s)

UW HSIP- Rejected No Name on Record

UW HSIP- Rejected Portal Submission 

UW HSIP- Rejected Result Trends 

UW HSIP- Rejected MMR Negative Titer(s) 

UW HSIP- Rejected MMR Invalid Age

UW HSIP- Rejected Varicella Neg Titer 

UW HSIP- Rejected HepB Dose #3 Invalid 

UW HSIP- Rejected HepB Dose #2 Invalid

UW HSIP- Rejected HepB Titer Submitted 

UW HSIP- Rejected HepB Titer Incorrect 

UW HSIP- Rejected HepB Titer Qualitative

UW HSIP- Rejected TB Screening Outdated 

UW HSIP- Rejected PPD Skin Test Single 

UW HSIP- Rejected PPD Skin Test Record 

UW HSIP- Rejected Td Submitted W/O Tdap 

UW HSIP- Rejected Tdap Vaccine Outdated 

UW HSIP- Rejected Flu Vaccine Outdated 

UW HSIP- Subsequent MMR Dose #2 

UW HSIP- Subsequent Varicella Dose #2 

   UW HSIP- Subsequent Tdap/Td Vaccine Dose 

UW HSIP- Negative Childhood Immunization 

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