Get the free Immunization Referral for Grades K – 12

This document serves as a referral for immunizations required for children in grades K – 12, outlining the necessary immunizations and processes to ensure compliance with Missouri school attendance

How to fill out immunization referral for grades

How to fill out Immunization Referral for Grades K – 12

1. Obtain the Immunization Referral form from your school or health department.
2. Fill in the student's personal information, including name, date of birth, and grade.
3. Provide details of any previous immunizations the student has received.
4. Indicate any medical exemptions or special considerations, if applicable.
5. Ensure that you have the parent or guardian's signature for consent.
6. Submit the completed form to the appropriate school or health authority.

Who needs Immunization Referral for Grades K – 12?

1. Students entering kindergarten.
2. Students transferring from another school.
3. Students who have not completed their immunization schedule.
4. Students returning after an extended absence.

People Also Ask about

Which vaccine is given at the age of 12?

Tetanus, diphtheria and pertussis booster: At age 11 or 12, we give a vaccine called Tdap. This vaccine is a booster to protect against three diseases: tetanus, diphtheria and pertussis (whooping cough). It's a slightly different version of a vaccine your child received as a baby (DTaP).

What vaccines are required for middle school in Virginia?

Effective July 1, 2019, a booster dose of the Tdap vaccine is required for all children entering the 7th grade. Effective July 1, 2021, a minimum of 2 doses of MenACWY vaccine. The first dose should be administered prior to entering 7th grade. The final dose should be administered prior to entering 12th grade.

What vaccines are required for 7th grade in California?

Shots Required for TK–12 and 7th Grade Diphtheria, Tetanus, and Pertussis (DTaP, DTP, Tdap, or Td) — 5 doses. (4 doses OK if one was given on or after 4th birthday. Polio (OPV or IPV) — 4 doses. Hepatitis B — 3 doses. Measles, Mumps, and Rubella (MMR) — 2 doses. Varice​lla​ (Chickenpox) — 2 doses.

Which meningitis vaccine is required for 12th grade in Illinois?

Students entering grade 12 in the State of Illinois must be immunized for Meningitis. The immunization requirement consists of two doses of the MCV4 vaccine for entry into 12th grade.

For pdfFiller’s FAQs

What is Immunization Referral for Grades K – 12?

Immunization Referral for Grades K – 12 is a process designed to ensure that students in grades K through 12 receive the necessary vaccinations as mandated by state health regulations. It involves referring students who are not up to date with their immunizations to appropriate health services for compliance.

Who is required to file Immunization Referral for Grades K – 12?

Schools are responsible for filing Immunization Referrals for students in grades K – 12 who are not in compliance with vaccination requirements. This typically includes school nurses or administrative staff who maintain vaccination records.

How to fill out Immunization Referral for Grades K – 12?

To fill out the Immunization Referral, gather the student's vaccination records, determine which immunizations are missing, and complete the referral form by providing necessary details such as the student's name, date of birth, grade, and specific immunizations required.

What is the purpose of Immunization Referral for Grades K – 12?

The purpose of the Immunization Referral for Grades K – 12 is to ensure that all students are protected against vaccine-preventable diseases, promote public health, and comply with state immunization laws for school attendance.

What information must be reported on Immunization Referral for Grades K – 12?

The information that must be reported on the Immunization Referral includes the student's personal information (name, date of birth, grade), a list of required immunizations that are missing, and any relevant health provider information for follow-up vaccinations.