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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. 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