OR DHS 53-05A 2019 free printable template
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Oregon Certificate of Immunization Status
Oregon Health Authority, Immunization Program
Oregon law requires proof of immunization be provided or an exemption be signed prior to a
children attendance
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How to fill out OR DHS 53-05A
01
Obtain a blank OR DHS 53-05A form from the official website or relevant office.
02
Fill in your personal information at the top of the form, including your name, address, and contact details.
03
Provide details about the service or assistance you are seeking in the designated sections.
04
Include any necessary documentation or evidence that supports your request.
05
Review the completed form for accuracy and completeness.
06
Sign and date the form where indicated.
07
Submit the form to the appropriate agency or office as instructed.
Who needs OR DHS 53-05A?
01
Individuals seeking assistance or services from the Oregon Department of Human Services (DHS).
02
Anyone applying for support programs, benefits, or services governed by DHS regulations.
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People Also Ask about
What vaccines are required in Oregon?
Immunization Requirements 2022-2023 4 doses - Diphtheria/Tetanus/Pertussis (DTaP) 3 doses - Polio. 1 dose - Varicella (chickenpox) 1 dose - Measles/Mumps/Rubella (MMR) 3 doses - Hepatitis B. 2 doses - Hepatitis A. 3 or 4 doses - Hib.
What are the 5 types of immunization?
As mentioned earlier, there are five main types of vaccines: attenuated (live) vaccines, inactivated vaccines, toxoid vaccines, subunit vaccines, and conjugate vaccines.
What's the difference between vaccine and immunized?
Vaccination: The act of introducing a vaccine into the body to produce protection from a specific disease. Immunization: A process by which a person becomes protected against a disease through vaccination.
What are the three types of immunization?
There are several types of vaccines, including: Inactivated vaccines. Live-attenuated vaccines. Messenger RNA (mRNA) vaccines.
What vaccines are required by law Oregon?
Oregon requires immunization against 11 vaccine-preventable diseases: Tetanus. Pertussis (whooping cough) Polio. Varicella (chickenpox) Measles. Mumps. Rubella. Hepatitis B.
Does the state of Oregon require vaccinations?
This is also true under Oregon law. On August 19, 2021, Governor Brown announced healthcare workers and all teachers, educators, support staff, and volunteers in K-12 schools would need to be fully vaccinated.
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What is OR DHS 53-05A?
OR DHS 53-05A is a form used by the Oregon Department of Human Services for reporting specific data related to public assistance programs.
Who is required to file OR DHS 53-05A?
Entities or individuals involved in certain public assistance programs as specified by the Oregon Department of Human Services are required to file OR DHS 53-05A.
How to fill out OR DHS 53-05A?
Filling out OR DHS 53-05A involves entering the required information accurately in the designated fields, referring to the instruction guide provided by the Oregon Department of Human Services.
What is the purpose of OR DHS 53-05A?
The purpose of OR DHS 53-05A is to collect and monitor data related to public assistance services to ensure compliance and improve service delivery.
What information must be reported on OR DHS 53-05A?
Information that must be reported on OR DHS 53-05A typically includes demographics of the individuals served, services provided, and outcomes related to the public assistance programs.
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