KY EPID-230C 2002 free printable template
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COMMONWEALTH OF KENTUCKY CHILDHOOD IMMUNIZATION LAW CERTIFICATE OF RELIGIOUS EXEMPTION Name of Child Birthdate Last First Middle Name of Parent or Guardian Address Street City State Zip Code RELIGIOUS EXEMPTION THE ABOVE NAMED CHILD IS HEREBY GRANTED A RELIGIOUS EXEMPTION OBJECTING TO IMMUNIZATION S ON RELIGIOUS GROUNDS. A SWORN STATEMENT FROM THE PARENT OR GUARDIAN IS ATTACHED. Signature of physician health dept. or their designee Date Address This Certificate should be presented to the...
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How to fill out KY EPID-230C
01
Obtain a copy of the KY EPID-230C form from the appropriate government website or office.
02
Fill out personal identification information at the top of the form, including name, address, and contact details.
03
Indicate the specific purpose of the form in the designated section.
04
Provide any relevant health information as requested, ensuring accuracy and completeness.
05
Review the form for any missing information or errors.
06
Sign and date the form at the bottom, certifying that all information provided is true and correct.
07
Submit the completed form to the appropriate agency or department, as instructed.
Who needs KY EPID-230C?
01
Individuals seeking to report a public health concern or illness.
02
Healthcare providers required to document specific health incidents.
03
Organizations involved in public health monitoring and epidemiology.
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People Also Ask about
Are vaccinations required for school in Kentucky?
Required Immunizations in Kentucky For kindergarten entry, all children at least 5 years of age must have: Five doses of DTaP or DTP (diphtheria, tetanus, pertussis) or combinations of the two vaccines. Four doses of IPV or OPV (polio) or combinations of the two vaccines.
What is the exemption form for immunizations in KY?
The state form EPID 230 the "Kentucky Certificate of Immunization Status," contains a checkbox for "Medical Exemption." This is the same form used to document all vaccines that a child has received.
What is the vaccine for children program in Kentucky?
The VFC program provides vaccines at no cost to eligible children through public and private providers enrolled in the program. All vaccines recommended by the Advisory Committee on Immunization Practices are available through the VFC program.
How do I get a Kentucky immunization certificate?
Visit KYIR Public Portal and follow the steps below to access your immunization record. You will be asked to enter information about yourself or your child to view and download/print records. To access your COVID-19 QR code online, download your COVID-19 Record from the KYIR Public Portal.
What is the vaccine exemption form for school in KY?
The state form EPID 230 the "Kentucky Certificate of Immunization Status," contains a checkbox for "Medical Exemption." This is the same form used to document all vaccines that a child has received.
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What is KY EPID-230C?
KY EPID-230C is a form used in the state of Kentucky for reporting epidemiological data related to infectious diseases.
Who is required to file KY EPID-230C?
Healthcare providers, laboratories, and facilities that diagnose or treat reportable infectious diseases in Kentucky are required to file KY EPID-230C.
How to fill out KY EPID-230C?
To fill out KY EPID-230C, collect the necessary patient information, complete all sections of the form as required, and submit it to the appropriate public health authority as directed.
What is the purpose of KY EPID-230C?
The purpose of KY EPID-230C is to collect standardized data on infectious diseases to monitor outbreaks, track epidemiological trends, and inform public health responses.
What information must be reported on KY EPID-230C?
KY EPID-230C requires reporting patient demographics, details of the infectious disease, laboratory results, and any relevant clinical information.
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