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Reviewed for compliance by: Staff Signature Date: Exemption: YES NO (see back) CERTIFICATE OF IMMUNIZATION STATUS Washington State Law (RCW 28A.21 0.160) requires that all children have a completed

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What is certificate of immunization status?

Certificate of immunization status is an official document that indicates whether an individual has received all required immunizations.

Who is required to file certificate of immunization status?

All students attending school or childcare facilities are required to file a certificate of immunization status.

How to fill out certificate of immunization status?

The certificate of immunization status can be filled out by a healthcare provider or by the individual's parent or guardian with information regarding the vaccines received by the individual.

What is the purpose of certificate of immunization status?

The purpose of the certificate of immunization status is to ensure that individuals attending school or childcare facilities are protected from vaccine-preventable diseases.

What information must be reported on certificate of immunization status?

The certificate of immunization status must include the individual's name, date of birth, vaccine doses received, and the dates they were administered.

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