immunization card

Printed by Immunization Action Coalition Saint Paul

I authorize the following individuals to collect my child from the facility in case of emergency or if I cannot be contacted: (Pursuant to R9-5-304.

Staff must record the required vaccine dose information and status of requirements for each pupil. See reverse side for guidance. CDPH 286 (10/23). Pupil Name ( 

Above signature is the signature of the school or health personnel who verified the Utah School Immunization Record (USIR) against the source record(s). VACCINE.

The School and Child Care Immunization Record has been moved to a new location: View new link: cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library 

Signature required if providing copy to parents or other school as official verification of immunization records. I certify that the immunization information 

California pre-kindergarten (child care or preschool) facilities are required to check immunizations for all new admissions and at each age checkpoint.

Immunization records often are needed for entry into child care schools

If you have questions regarding immunizations or how to complete this form

MISSOURI. IMMUNIZATION RECORD. OFFICIAL DOCUMENT. Retain this document as proof of immunizations. According to Missouri law your.

Arizona Department of Health Services. Bureau of Child Care Licensing. Emergency Information and Immunization Record Card. Child's Name: Date Enrolled:.

Immunization records often are needed for entry into child - only those vaccine doses that are documented on a written record or are available on a ...

Jul 18 2022 You should get a card when you get your COVID-19 vaccination that includes the name of the vaccine product and the date you got it.

(Personal immunization records may include the yellow California Immunization Record or other printout from a doctor's office or clinic.) 2. Complete a 

VACCINES THAT MAY BE RECORDED ON IMMUNIZATION RECORDS. Abbreviations for Vaccines. Abbreviations. Vaccine. DT. Pediatric Diphtheria and Tetanus.

If you do not have an immunization record for this student at home contact your doctor or public health department to obtain it. TYPE OF VACCINE*. FIRST DOSE.

child's immunizations and transcribed it accurately: Date. Staff. Signature. Record Presented was: Yellow California Immunization Record.

To obtain a copy of your immunization record we use the Massachusetts Immunization. Information System (MIIS)

IMMUNIZATION RECORD. Instructions for uploading immunizations: Step 1: Go to www.myuhc.umd.edu. Step 2: Enter your directory ID and password to log on 

NEW JERSEY IMMUNIZATION INFORMATION SYSTEM (NJIIS). REQUEST FOR CHANGE TO NJIIS IMMUNIZATION RECORD. Please attach documents to identify the person 

To meet the space constraints of this form and federal requirements fordocumentation a healthcare setting may want to keep a reference list ofvaccinators that includes their initials and titles Immunization Action Coalition Saint Paul Minnesota 651-647-9009 www immunize www vaccineinformation

www immunize org/catg d/p2022 pdf • Item #P2022 (4/16) Vaccine Administration Record for Children and Teens (continued) Before administering any vaccines give copies of all pertinent Vaccine Information Statements (VISs) to the child’s parent or legal representative and make sure he/she understands the risks and benefits of the vaccine(s)

Immunization records often are needed for entry into childcare schools camps and new jobs as well as travel abroad If you are seeing a new healthcare provider you will need this information to ensure you receive proper medical care Providers usually count only those vaccine doses that are documented in a written record or a state or

Recommended Adult Immunization Schedule by Medical Condition or Other Indication United States 2023 Recommended vaccination Recommended vaccination for adults who meet for adults with an additional age requirement lack risk factor or another documentation of indicationvaccination or lack evidence of past infection a

official immunization records online at wa myir net Talk to your doctor or clinic about your immunization questions or visit the Washington State Department of Health at doh wa gov/immunization Zoster (shingles) Product* Physician/Clinic Other Vaccines Vaccine Physician/Clinic Next Due Date Tuberculosis (TB) Test Physician/Clinic TST or QFT-G

The California Immunization Registry (CAIR2) is a secure web-based system available to health care providers including local health departments community clinics private medical offices and hospitals as well as other approved agencies such as schools child care facilities and foster care