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This document is a medical immunization form required by Providence College and Rhode Island State law for all full-time students to ensure immunity compliance before registration.

How to fill out mandatory immunization record

How to fill out MANDATORY IMMUNIZATION RECORD

1. Obtain the MANDATORY IMMUNIZATION RECORD form from your healthcare provider or relevant health authority.
2. Fill in the personal information section with your full name, date of birth, and contact details.
3. List all immunizations received in the appropriate section, including the vaccine name, date of administration, and the provider's signature.
4. Ensure that any required documentation, such as proof of vaccination, is attached to the form.
5. Review the completed form for accuracy and completeness.
6. Submit the form to the necessary school or health authority as instructed.

Who needs MANDATORY IMMUNIZATION RECORD?

1. Individuals enrolling in schools or daycare centers.
2. Travelers going to certain countries requiring immunization records.
3. Participants in specific programs or employment that mandate vaccinations.

People Also Ask about

What do you need to document before giving an injection?

What information does federal law require us to document when we immunize a patient? The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered. The name, office address, and title of the healthcare provider administering the vaccine.

What needs to be documented when giving a vaccine?

By law, the following information must be documented on the patient's paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.

What should be documented after administering an injection?

Procedure note documentation requirements include: Diagnosis or indication for injection. Site of injection, eye(s) treated. Medication name, how much was injected (in milligrams and volume in milliliters) and lot number. How much of a drug is wasted. Route of administration.

Does my college have my immunization records?

Check with your high school and/or college health services for dates of any immunizations. Keep in mind that generally records are kept only for 1-2 years after students leave the system.

What are the eight details that must be documented when a vaccination is given?

Immunization providers are required by law to record what vaccine was given, the date the vaccine was given (month, day, year), the name of the manufacturer of the vaccine, the lot number, the signature and title of the person who gave the vaccine, and the address where the vaccine was given.

How to get immunization records in New York?

You should contact your or your child's previous health care provider, the last school you or your child attended, the New York State Department of Health, or your local (county) health department for your immunization records.

What are 8 details that must be documented when a vaccination is given?

Immunization providers are required by law to record what vaccine was given, the date the vaccine was given (month, day, year), the name of the manufacturer of the vaccine, the lot number, the signature and title of the person who gave the vaccine, and the address where the vaccine was given.

For pdfFiller’s FAQs

What is MANDATORY IMMUNIZATION RECORD?

A Mandatory Immunization Record is an official document that tracks an individual's vaccination history, ensuring compliance with public health requirements.

Who is required to file MANDATORY IMMUNIZATION RECORD?

Individuals, typically children entering school or certain healthcare settings, are required to file a Mandatory Immunization Record to demonstrate that they have received the necessary vaccinations.

How to fill out MANDATORY IMMUNIZATION RECORD?

To fill out the Mandatory Immunization Record, one should provide all required personal details, enter the dates of vaccinations received, include the type of vaccines given, and ensure that the record is signed by a healthcare provider.

What is the purpose of MANDATORY IMMUNIZATION RECORD?

The purpose of the Mandatory Immunization Record is to ensure public health safety by documenting vaccinations, preventing outbreaks of vaccine-preventable diseases, and ensuring compliance with state and local laws.

What information must be reported on MANDATORY IMMUNIZATION RECORD?

The Mandatory Immunization Record must report the individual's name, date of birth, vaccination dates, types of vaccines administered, and the signature of the healthcare provider who administered the vaccines.