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This document is used to collect and maintain immunization records for students enrolled in a Minnesota college or university, as required by law.
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How to fill out student immunization record
How to fill out STUDENT IMMUNIZATION RECORD
01
Obtain the STUDENT IMMUNIZATION RECORD form from your school or healthcare provider.
02
Fill in the student's full name, date of birth, and other identifying information at the top of the form.
03
List all required vaccinations, including the vaccination name, date administered, and the administering healthcare provider.
04
Ensure that all dates are accurate and reflect the official immunization records.
05
If applicable, provide documentation of any exemptions or medical contradictions.
06
Review the completed form for any missing information or errors.
07
Sign and date the form where required, confirming the information is correct.
Who needs STUDENT IMMUNIZATION RECORD?
01
All students enrolling in school for the first time.
02
Students transferring between schools or districts.
03
Students who are participating in certain extracurricular activities or sports.
04
Students attending childcare or early childhood education programs.
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What is STUDENT IMMUNIZATION RECORD?
The Student Immunization Record is a document that records the immunizations that a student has received, including vaccines required for school attendance.
Who is required to file STUDENT IMMUNIZATION RECORD?
Parents or guardians of students are required to file the Student Immunization Record to ensure compliance with state vaccination requirements for school attendance.
How to fill out STUDENT IMMUNIZATION RECORD?
To fill out the Student Immunization Record, parents or guardians should provide the student's personal information, list the vaccines administered along with their dates, and ensure that the form is signed by a healthcare provider if required.
What is the purpose of STUDENT IMMUNIZATION RECORD?
The purpose of the Student Immunization Record is to help schools maintain accurate health records, ensure that students are up-to-date with their vaccinations, and protect public health by preventing outbreaks of vaccine-preventable diseases.
What information must be reported on STUDENT IMMUNIZATION RECORD?
The information that must be reported on the Student Immunization Record includes the student's name, date of birth, vaccination dates, types of vaccines received, and the name and signature of the healthcare provider who administered the vaccines.
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