Get the free from CHILD Profile Immunization Registry

Certificate of Immunization Status (CIS) DOH 348-013 January 2010 Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Registry. Child s Last

How to fill out from child profile immunization

How to fill out a child's profile immunization form:

1. Gather all necessary information: Before starting to fill out the form, make sure you have the child's personal information, including their full name, date of birth, and any medical history related to immunizations.
2. Review the immunization schedule: Familiarize yourself with the recommended immunization schedule for children. This can typically be found on government health websites or from your child's healthcare provider.
3. Record the previous immunizations: The form may require you to provide details about the child's previous immunizations. Gather any records or documents you have that show the dates and types of vaccines they have received in the past.
4. Fill in the current immunizations: Based on the recommended immunization schedule, record the vaccines that the child has already received. Be sure to include the dates of administration and any specific information requested on the form.
5. Check for additional requirements: Some forms may have additional sections or questions that need to be filled out. These could include any medical exemptions or alternative vaccination schedules. Take your time to read through the form carefully and provide accurate information.
6. Obtain signatures: The form may require signatures from both the parent or guardian and the healthcare provider. Make sure that all required signatures are obtained before submitting the form.

Who needs a child profile immunization?

1. All children: Immunizations are recommended for all children to protect them from vaccine-preventable diseases. It is important for children to receive their necessary immunizations to safeguard their health and prevent the spread of infectious diseases.
2. Parents and guardians: Parents and guardians are responsible for ensuring that their child receives the recommended immunizations. By keeping their child's immunization profile up to date, parents and guardians are contributing to the overall health and well-being of their child as well as their community.
3. Healthcare providers: Healthcare providers play a crucial role in administering immunizations and maintaining accurate records of a child's immunization history. They are responsible for completing and updating the child profile immunization form as needed, as well as providing guidance and information to parents and guardians regarding the importance of immunizations.

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