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Get the free Oregon Certificate of Immunization Status - State of Oregon

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YMCA SCHOOL AGE CHILD CARE 20182019 SCHOOL YEAR REGISTRATION Please only list ONE CHILD PER FORM and attach a recent WALLET SIZE PHOTO AND IMMUNIZATION CERTIFICATE. Print legibly, complete all fields
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How to fill out oregon certificate of immunization

01
Obtain a copy of the Oregon Certificate of Immunization form from your healthcare provider or the Oregon Health Authority website.
02
Fill in the personal information section, including your name, date of birth, and contact information.
03
Provide details about your immunization history, including the names of the vaccines received, the dates of administration, and the healthcare provider who administered them.
04
If you have any medical exemptions or delayed immunizations, provide documentation or explanation as required.
05
Review the completed form for accuracy and completeness.
06
Sign and date the form to certify the accuracy of the information provided.
07
Submit the completed form to your healthcare provider or the relevant authority as required.

Who needs oregon certificate of immunization?

01
The Oregon Certificate of Immunization is typically needed for individuals who require proof of immunization status. This may include students enrolling in schools or colleges, employees in certain healthcare or childcare settings, and individuals participating in certain activities or events that have immunization requirements.
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The Oregon Certificate of Immunization is an official document that records the immunization status of a person, indicating which vaccines have been received.
Parents or guardians of children entering school, as well as adults in certain situations such as healthcare facilities or college enrollment, are required to file the Oregon Certificate of Immunization.
To fill out the Oregon Certificate of Immunization, provide the individual's personal information, list the vaccines received, including dates, and include the provider's signature or clinic information.
The purpose of the Oregon Certificate of Immunization is to ensure that individuals are vaccinated as required by state law, thereby helping to prevent the spread of vaccine-preventable diseases.
The information that must be reported includes the individual's name, date of birth, vaccines received, dates of immunizations, and the healthcare provider's information.
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