Get the free Colorado Certificate of Immunization

COLORADO LAW REQUIRES THIS FORM BE COMPLETED AND PROVIDED TO THE SCHOOL Name Date of Birth Parent/Guardian COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENTCERTIFICATE OF IMMUNIZATION VACCINE Enter

How to fill out colorado certificate of immunization

How to fill out Colorado Certificate of Immunization:

1. Download the Colorado Certificate of Immunization form from the official website of the Colorado Department of Public Health and Environment.
2. Fill in the personal information section at the top of the form. Provide your full name, date of birth, and contact information.
3. Under the "Vaccines Administered" section, begin by entering the date of each vaccine administration in the first column.
4. In the second column, specify the type of vaccine administered (e.g., Measles, Mumps, Rubella).
5. In the third column, indicate the manufacturer of the vaccine.
6. The fourth column should be used to record the lot number of the vaccine.
7. If applicable, indicate the date of each vaccine's expiration in the fifth column.
8. In the "Physician or Health Care Provider Certification" section, include the provider's name, address, and telephone number.
9. The provider must sign and date the form to certify the accuracy of the information provided.
10. Finally, review the completed form for any errors or omissions before submitting it.

Who needs Colorado Certificate of Immunization?

1. Students: Colorado law requires all students attending preschool, K-12 schools, and colleges to provide a completed Certificate of Immunization.
2. Healthcare Workers: Healthcare workers in Colorado, including but not limited to doctors, nurses, and medical staff, may need to provide a Certificate of Immunization as part of their employment requirements.
3. Individuals participating in certain activities: Some activities, such as attending child care centers, summer camps, or enrolling in specific programs, may also require a completed Certificate of Immunization.

Remember, it is advisable to consult the official guidelines and regulations set by the Colorado Department of Public Health and Environment for specific requirements and exemptions related to the Certificate of Immunization.

For pdfFiller’s FAQs

What is colorado certificate of immunization?

Colorado certificate of immunization is an official document that proves an individual has received certain vaccinations.

Who is required to file colorado certificate of immunization?

All students attending school in Colorado are required to provide a certificate of immunization.

How to fill out colorado certificate of immunization?

Colorado certificate of immunization can be filled out by a healthcare provider or a public health department after administering the required vaccinations.

What is the purpose of colorado certificate of immunization?

The purpose of Colorado certificate of immunization is to ensure that individuals are protected against vaccine-preventable diseases.

What information must be reported on colorado certificate of immunization?

Colorado certificate of immunization must include the individual's name, date of birth, the administered vaccines, and the dates they were given.

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