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UT-Houston Medical School Health Service 6410 Fannie Suite 1010 Phone: (713) 500-5171 Fax: (713) 500-0605 CERTIFICATION OF IMMUNIZATION Please return this form to UT-Houston Medical School Health
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The immunization form - blue is a specific form used to record and report immunization records of individuals.
Healthcare providers, schools, or other organizations responsible for maintaining immunization records are required to file the immunization form - blue.
To fill out the immunization form - blue, you need to provide the individual's personal information, such as name and date of birth, and record the details of their immunizations, including the type of vaccine, dates received, and dosage.
The purpose of the immunization form - blue is to serve as an official record of an individual's immunization history in order to track and monitor their vaccination status.
The immunization form - blue requires the reporting of personal information of the individual, details of their immunizations including vaccine type, dates received, and dosage, as well as any adverse reactions or contraindications.
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