Get the free Certificate of Immunization Status form - Tacoma Public Schools

Certificate of Immunization Status (CIS) DOH 348-013 January 2010 Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Registry. Child s Last

How to fill out certificate of immunization status

How to Fill Out a Certificate of Immunization Status:

1. Begin by gathering all the necessary information and documents. This includes the immunization records of the person for whom the certificate is being filled out.
2. Start by providing basic personal information. Fill out the person's full name, date of birth, gender, and any other required personal details.
3. Next, list the specific vaccines that have been administered to the individual. Include the name of the vaccine, date administered, and dose number. Make sure to accurately record this information from the immunization records.
4. If there are any vaccines that the person is exempt from or have religious or medical contraindications, indicate this on the certificate form. Some forms may require additional documentation to support these exemptions.
5. Include the signature and contact information of the healthcare provider or organization responsible for administering the vaccines. This may include their name, title, phone number, and address.
6. Double-check all the information provided on the certificate to ensure accuracy and completeness. Any errors or missing details may delay the processing of the certificate.

Who Needs a Certificate of Immunization Status:

1. Students: Many educational institutions, such as schools and colleges, require students to provide a certificate of immunization status as a part of enrollment or registration. It serves as evidence that the student has received the necessary vaccinations to prevent the spread of communicable diseases within the campus community.
2. Healthcare Workers: Individuals working in the healthcare sector, including doctors, nurses, and other medical professionals, often need to submit a certificate of immunization status. This ensures that they are adequately protected against various infectious diseases and can safely provide care to their patients.
3. Travelers: Certain countries or regions may require travelers to provide a certificate of immunization status as part of their visa or entry requirements. This helps protect the local population from the introduction and spread of diseases that might be prevalent in the traveler's home country.
4. Employees: Some employers, especially those in healthcare, childcare, or food handling industries, may ask their employees to provide a certificate of immunization status. This is to ensure a safe working environment and minimize the risk of disease transmission among staff and customers.
5. Volunteers and Participants in Public Programs: Individuals participating in public programs, like volunteer initiatives, community events, or certain government programs, may be asked to show a certificate of immunization status. This is done to safeguard the health and well-being of all involved parties.

It is important to note that the specific requirements for a certificate of immunization status may vary depending on the jurisdiction, organization, or purpose for which it is needed. Therefore, it is crucial to refer to the specific guidelines and instructions provided by the relevant authorities when filling out and submitting such certificates.

For pdfFiller’s FAQs

What is certificate of immunization status?

The certificate of immunization status is a document that verifies an individual's vaccination history.

Who is required to file certificate of immunization status?

Individuals, typically students, 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 providing information on the individual's vaccinations and dates received.

What is the purpose of certificate of immunization status?

The purpose of the certificate of immunization status is to ensure that individuals are up to date on their vaccinations and protect public health.

What information must be reported on certificate of immunization status?

The certificate of immunization status must include information on the individual's name, date of birth, vaccinations received, and dates received.

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