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Exhibit # JLCBE1 ARIZONA SCHOOL IMMUNIZATION RECORD FOR SCHOOL USE ONLY This form must be completed from an immunization record provided by parent or guardian. See reverse side for instructions. Enrollment
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How to fill out arizona school immunization record

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How to fill out an Arizona school immunization record:

01
Obtain the form: Contact your child's school or the Arizona Department of Health Services to obtain a copy of the Arizona school immunization record form.
02
Gather necessary information: Collect your child's immunization records from healthcare providers, including dates of immunizations and the types of vaccines received.
03
Complete personal information: Fill in your child's personal information on the form, including their full name, date of birth, and address.
04
Record previous immunizations: Refer to your child's immunization records and accurately record the dates and types of vaccines they have received in the appropriate sections of the form.
05
Enter exemptions or waivers: If your child has a medical or religious exemption or waiver for certain vaccines, provide the necessary documentation and complete the exemption section of the form.
06
Validate the information: Before submitting the form, double-check all the information entered to ensure accuracy and completeness.
07
Submit the form: Return the completed Arizona school immunization record form to your child's school or the designated authority as per their instructions.

Who needs an Arizona school immunization record:

01
Kindergarten students: All kindergarten students attending public or private schools in Arizona are required to provide a completed Arizona school immunization record.
02
Seventh-grade students: Similarly, all seventh-grade students in Arizona schools must have a completed immunization record.
03
Transfer students: Students transferring from another state or country to an Arizona school are also required to provide an Arizona school immunization record to ensure compliance with the state's immunization requirements.
04
Enrollment in other grades: While not mandatory for enrollment in other grade levels, it is often requested that students provide an immunization record to promote public health and safety within the school community.
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Arizona school immunization record is a document that contains information about the immunization history of a student attending a school in Arizona.
Parents or guardians of students attending school in Arizona are required to file the arizona school immunization record.
To fill out arizona school immunization record, parents or guardians need to provide information about the student's immunization history, including the dates and types of vaccines received.
The purpose of arizona school immunization record is to ensure that students attending school in Arizona are properly vaccinated to prevent the spread of vaccine-preventable diseases.
Information that must be reported on arizona school immunization record includes the student's name, date of birth, immunizations received, dates of immunizations, and healthcare provider information.
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