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Certificate of Immunization Name Address Birthdate Phone Parent/Guardian (print) Vaccine (Circle appropriate item) Diphtheria & Tetanus (Tap, DTP, TD or DT) Doses Enter month, day, and year each immunization
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What is certificate of immunization?
The certificate of immunization is a document that verifies an individual has received specific vaccinations or immunizations.
Who is required to file certificate of immunization?
Typically, students, travelers, and healthcare workers are required to file a certificate of immunization.
How to fill out certificate of immunization?
To fill out a certificate of immunization, one must provide information on the vaccines received, dates of administration, and healthcare provider details.
What is the purpose of certificate of immunization?
The purpose of the certificate of immunization is to ensure individuals have received necessary immunizations to prevent the spread of vaccine-preventable diseases.
What information must be reported on certificate of immunization?
The certificate of immunization must report details on the vaccines received, dates of administration, and healthcare provider information.
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