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CO Certificate of Immunization 2023-2025 free printable template

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COLORADO CERTIFICATE OF IMMUNIZATION www.coloradoimmunizations.com This form is to be completed by a health care provider (physician (MD, DO), advanced practice nurse (APN) or delegated physicians
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CO Certificate of Immunization Form Versions

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CO Certificate of Immunization 2023
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CO Certificate of Immunization 2018
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How to fill out CO Certificate of Immunization

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How to fill out CO Certificate of Immunization

01
Obtain a blank CO Certificate of Immunization form from your healthcare provider or state health department.
02
Fill out the student's personal information, including their name, date of birth, and school information.
03
List all required immunizations, including the type of vaccine and the dates each dose was given.
04
Make sure to include any additional vaccines that may be recommended for the student.
05
Have a licensed healthcare provider sign and date the certificate to verify its accuracy.
06
Review the completed form for any errors or missing information before submission.
07
Submit the completed CO Certificate of Immunization to the student's school or childcare facility.

Who needs CO Certificate of Immunization?

01
Students entering Kindergarten or 7th grade in Colorado.
02
New students transferring into a Colorado school.
03
Students attending childcare facilities or preschools.
04
Individuals seeking to participate in certain sports or extracurricular activities that require immunization verification.
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COLORADO CERTIFICATE OF IMMUNIZATION This form is to be completed by a health care provider (physician (MD, DO), advanced practice nurse (APN) or delegated physician's assistant (PA)) or school health authority. School required immunizations follow the ACIP schedule.
The Colorado Immunization Information System (CIIS) is a lifelong immunization record tracking system under the Colorado Immunization Registry Act of 2007. CIIS has signed agreements with all participating sites that are authorized to provide information to or access information from CIIS.
Your vaccination record (sometimes called your immunization record) provides a history of all the vaccines you received as a child and adult. This record may be required for certain jobs, travel abroad, or school registration.
Patients and guardians of minors can now use the CIIS Public Portal to view and print an official record of their immunizations.
Vaccines required to enter school (K-12) *Students 4 through 6 years of age are required to have their final doses of DTaP, IPV,MMR and Varicella prior to kindergarten entry. **Students are required to have Tdap prior to entry into 6th grade. One dose of Tdap is required for 6th through 12th grades.

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The CO Certificate of Immunization is an official document that verifies an individual's immunization status, particularly for certain vaccines required to attend school or childcare in Colorado.
Parents or guardians of children entering school or childcare in Colorado are required to file the CO Certificate of Immunization to ensure that their child meets the vaccination requirements.
To fill out the CO Certificate of Immunization, one needs to provide the child's personal information, vaccination history, including dates and types of vaccines received, and the signature of a healthcare provider who administered the vaccines.
The purpose of the CO Certificate of Immunization is to protect the health of children and the community by ensuring that children are vaccinated against preventable diseases before they attend school or childcare.
The CO Certificate of Immunization must report the child's name, date of birth, the dates of each vaccination received, the types of vaccines administered, and the signature and contact information of the healthcare provider.
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