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2015 Amherst College Keeffe Health Center PO Box 5000, Amherst, MA 01002 phone:413.542.2267fax:413.542.2647 health service Amherst.edu MASSACHUSETTS REQUIRED IMMUNIZATION HISTORY This form must be
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How to fill out Massachusetts required immunization history:

01
Obtain the necessary forms: Contact your child's school or healthcare provider to get the specific Massachusetts required immunization forms.
02
Gather the required information: Collect all relevant immunization records for your child. This includes dates and types of vaccines received.
03
Fill in personal information: Start by providing your child's name, date of birth, and contact information at the top of the form.
04
Provide immunization details: Fill in the required fields for each immunization your child has received. Include the vaccine name, date administered, and the name of the healthcare provider who administered it.
05
Attach supporting documentation: If your child has received immunizations outside of Massachusetts, make sure to attach any supporting documentation, such as copies of immunization records or official forms from other states or countries.
06
Review and sign: Carefully review all the entered information for accuracy. Once verified, sign and date the form.
07
Submit the form: Send the completed form to the appropriate recipients. This could be your child's school or healthcare provider, depending on their requirements.

Who needs Massachusetts required immunization history?

01
All children attending schools in Massachusetts: The Massachusetts Department of Public Health requires all children attending schools, from preschool to college, to have up-to-date immunization records on file.
02
Children enrolling in daycare or childcare programs: Similar to schools, daycare centers and childcare programs in Massachusetts also require children to have their immunization history documented.
03
Individuals entering certain healthcare programs or professions: Some healthcare programs and professions in Massachusetts mandate proof of immunization to ensure the safety and protection of both patients and healthcare providers. Requirements may vary depending on the specific program or profession.
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Massachusetts required immunization history includes a record of all immunizations received by an individual.
All residents of Massachusetts, including children and adults, are required to file their immunization history.
Massachusetts required immunization history can be filled out by providing a record of all immunizations received, including dates and types of vaccines administered.
The purpose of Massachusetts required immunization history is to ensure that residents are up-to-date on their vaccinations and to prevent the spread of vaccine-preventable diseases.
On Massachusetts required immunization history, individuals must report all vaccines received, dates of administration, and any exemptions or waivers.
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