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U.S. Coast Guard Academy Regional Clinic fax number

(860) 701-6665

Immunization Department

Used for: Submitting immunization records and related medical documents to the USCGA Regional Clinic

Fax destination details

Department
Immunization Department
Purpose
Submitting immunization records and related medical documents to the USCGA Regional Clinic
Form
Immunization Record Form — Immunization Record Form (Direct Commission Officer / Officer Candidate / Selected Reserve Direct Commission)
Address
CG Academy Regional Clinic, USCGA, 15 Mohegan Ave., New London, CT 06320
Voice phone
860-701-6155

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Fax the completed Immunization Record Form and lab reports to 860-701-6665. Make two photocopies of the form and lab reports; mail the original to USCGA Regional Clinic, Attn: Immunization Department, USCGA, 15 Mohegan Ave., New London, CT 06320. Use blue/black ink and print clearly; include name and SSN on each page.

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