Get the free STUDENT IMMUNIZATION RECORD - dsd.k12.wi.us

DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Public Health F-04020L (Rev. 07/12) 252.04 and 120.12 (16) Wis. Stats. STUDENT IMMUNIZATION RECORD.

How to fill out student immunization record

How to fill out student immunization record?

1. Gather necessary information: Start by collecting all the required information for the student immunization record. This includes the student's personal details such as name, date of birth, and contact information.
2. Review immunization requirements: Familiarize yourself with the immunization requirements set by your state or educational institution. This will help ensure that the record is filled out accurately and all necessary immunizations are documented.
3. Obtain immunization records: Obtain the immunization records from the student's healthcare provider or previous educational institution. These records will contain details about the specific vaccines received and the dates they were administered.
4. Enter personal information: Begin filling out the student immunization record by entering the student's personal information, including their full name, date of birth, gender, and contact information. Make sure to write legibly and use accurate information.
5. Record vaccine doses: Create a section on the record to document the different vaccine doses received by the student. Write the name of the vaccine, the date it was given, the healthcare provider who administered it, and the dosage received. If necessary, leave space for additional vaccines to be added in the future.
6. Include exemptions or waivers: If the student has any exemptions or waivers from certain immunizations due to medical or religious reasons, make sure to document them accordingly. Note the specific exemption type and any supporting documentation provided.
7. Review and verify: Once all the necessary information has been entered, thoroughly review the student immunization record for accuracy. Double-check the names, dates, and vaccine details to ensure they are correct.

Who needs student immunization record?

1. Students: All students, regardless of age or grade level, typically need a student immunization record. This is to ensure that they meet the immunization requirements set by their state or school district.
2. Schools and educational institutions: Student immunization records are essential for schools and educational institutions to maintain a safe and healthy environment. These records help verify that students are adequately protected against vaccine-preventable diseases.
3. Healthcare providers: Healthcare providers, such as doctors, nurses, and other medical professionals, may need access to a student's immunization record to provide appropriate care or administer additional vaccines.
4. Parents or guardians: Parents or guardians are responsible for providing accurate and up-to-date immunization records for their children. These records may be requested by schools, camps, sports teams, or other organizations to ensure compliance with immunization requirements.

In conclusion, filling out a student immunization record involves gathering necessary information, reviewing immunization requirements, obtaining immunization records, entering personal information, recording vaccine doses, including exemptions or waivers, and thoroughly reviewing and verifying the record. This record is needed by students, schools, healthcare providers, and parents or guardians to ensure compliance with immunization requirements and maintain a safe and healthy environment.

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What is student immunization record?

Student immunization record is a document that shows a student's immunization history, including vaccines received and dates.

Who is required to file student immunization record?

Parents or guardians of students are typically required to file the student immunization record with the school or educational institution.

How to fill out student immunization record?

Student immunization records can be filled out by providing information about the student's vaccines, including the name of the vaccine, date administered, and healthcare provider.

What is the purpose of student immunization record?

The purpose of student immunization record is to ensure that students are up to date on required vaccines to protect against preventable diseases and to maintain a healthy school environment.

What information must be reported on student immunization record?

Student immunization records must typically include information about the vaccines received by the student, dates of administration, and any exemptions or waivers.