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Division of Women Youth & Children
Community Health Programs
School Immunization Program
URN
(Office use only)Request for School Immunization Record
Under the Act Health Records (Privacy and Access)
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How to fill out request for school immunisation
How to fill out request for school immunisation
01
Obtain the school immunisation request form from your child's school or the local health department.
02
Fill out the basic information section of the form, including your child's name, date of birth, and contact information.
03
Provide information about your child's immunisation history, including any previous vaccinations received.
04
Review the school's immunisation requirements and make sure your child meets the necessary criteria.
05
If your child requires any specific vaccinations, consult your healthcare provider to ensure they are up to date.
06
Sign and date the request form to acknowledge your consent for the school to immunise your child.
07
Submit the completed request form to the designated school or health department office.
08
Keep a copy of the form for your records.
09
Follow up with the school or health department to confirm the status of your request and any additional steps required.
Who needs request for school immunisation?
01
Any student who meets the school's immunisation requirements needs to submit a request for school immunisation.
02
Typically, this includes students entering a new school or grade level, as well as those who have not provided proof of immunisation in the past.
03
Each school may have its own specific requirements, so it is important to consult the school's guidelines to determine if a request is necessary.
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What is request for school immunisation?
Request for school immunisation is a form that needs to be submitted to the school by parents or guardians in order for their child to receive required vaccinations.
Who is required to file request for school immunisation?
Parents or guardians of school-aged children are required to file request for school immunisation.
How to fill out request for school immunisation?
Request for school immunisation can be filled out by providing personal and medical information about the child, as well as submitting documentation of completed vaccinations.
What is the purpose of request for school immunisation?
The purpose of request for school immunisation is to ensure that all children attending school are up-to-date on their required vaccinations to prevent the spread of communicable diseases.
What information must be reported on request for school immunisation?
Information such as child's personal details, vaccination history, and any exemptions must be reported on request for school immunisation.
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