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Documentation of Trap Administration or Medical Exemption Optional Form for Health Care Providers A) Administration of Trap STUDENT NAME (Last, First, Middle) DATE OF Trap NAME OF CHILD S PHYSICIAN
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How to fill out imm-1037 doc tdap administration2
To fill out the imm-1037 doc tdap administration2, follow these steps:
01
Begin by writing the date in the designated space on the form.
02
Provide your full name, address, and contact information in the appropriate fields.
03
Enter your date of birth and sex in the designated spaces.
04
Specify the vaccination details, including the date of administration and the vaccine lot number.
05
Indicate the specific Tdap vaccine given.
06
If relevant, state any adverse reactions or side effects experienced after receiving the vaccine.
07
Sign and date the form to complete the process.
The imm-1037 doc tdap administration2 is typically needed by individuals who have received the Tdap vaccine. This form serves as a record of the vaccination, detailing important information such as the date of administration and any adverse reactions. It is commonly required for school entry, employment, or medical purposes to provide proof of vaccination.
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