KS Certificate of Immunization (KCI) 2018 free printable template
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KANSAS CERTIFICATE OF IMMUNIZATIONS (PCI) This record is part of the student's permanent record and shall be transferred from one school to another as defined in Section 726262 (d) of the Kansas School
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How to fill out KS Certificate of Immunization KCI
How to fill out KS Certificate of Immunization (KCI)
01
Obtain the KS Certificate of Immunization (KCI) form from your healthcare provider or the Kansas Department of Health and Environment website.
02
Fill in the student's personal information including their name, date of birth, and address.
03
List all vaccines the student has received along with the dates they were administered.
04
Ensure that the immunization records are signed or stamped by a licensed healthcare provider to verify the information.
05
Submit the completed KCI form to the school or institution that requires it.
Who needs KS Certificate of Immunization (KCI)?
01
Students enrolling in schools in Kansas.
02
Children entering childcare or preschool programs.
03
College students as part of their admission requirements.
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What is KS Certificate of Immunization (KCI)?
The KS Certificate of Immunization (KCI) is a document that certifies an individual's immunization status, specifically for vaccinations required by the state of Kansas for school entry and attendance.
Who is required to file KS Certificate of Immunization (KCI)?
Individuals enrolling in schools or daycare facilities in Kansas are required to file the KS Certificate of Immunization (KCI) to demonstrate compliance with state vaccination requirements.
How to fill out KS Certificate of Immunization (KCI)?
To fill out the KS Certificate of Immunization (KCI), obtain the form from a healthcare provider, complete the personal information section, list all required vaccinations received, and ensure that the provider signs and dates the certificate.
What is the purpose of KS Certificate of Immunization (KCI)?
The purpose of the KS Certificate of Immunization (KCI) is to ensure that individuals meet the immunization requirements set by the state for public health safety, particularly for school and daycare admission.
What information must be reported on KS Certificate of Immunization (KCI)?
The KS Certificate of Immunization (KCI) must report personal identifiers (name, date of birth), vaccination history (types of vaccines, dates administered), and the signature of a healthcare provider or authorized official.
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