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Download and complete the Hepatitis B form

Dual Enrollment students must submit a copy of the Hepatitis B form. The form does not have to be signed by a doctor but must be signed by a parent or guardian for students under 18. Please download the Hepatitis B form and email, mail, or fax the completed form to the address below. 

Students who are 18 or older may log into their myPellissippi account to respond to the Hepatitis B question in lieu of submitting the form.  They may also complete and sign the form themselves.

Spencer Joy
P.O. Box 22990
Knoxville, TN 37933
Fax: 865-539-7690