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CONSENT TO TREAT A MINOR (if applicable)Fathers Name: ___ DOB ___/___/___ Address: ___ City: ___ State: ___ Zip:___ Phone:___ (OK to call Y/N) Mothers Name: ___ DOB ___/___/___ Address: ___ City:
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How to fill out transferring out-of-state immunization records

How to fill out transferring out-of-state immunization records
01
Contact the school or organization where the immunization records need to be transferred.
02
Request a copy of the out-of-state immunization records from the previous school or healthcare provider.
03
Fill out any necessary forms provided by the new school or organization for transferring immunization records.
04
Ensure all required immunizations are documented on the records, including dates and types of vaccinations.
05
Submit the completed forms and immunization records to the new school or organization for processing.
Who needs transferring out-of-state immunization records?
01
Students transferring to a new school in a different state.
02
Employees moving to a new job location in a different state.
03
Individuals seeking healthcare services in a different state.
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What is transferring out-of-state immunization records?
Transferring out-of-state immunization records refers to the process of moving vaccination information from one state's immunization registry to another, typically when an individual moves to a new state.
Who is required to file transferring out-of-state immunization records?
Individuals, usually parents or guardians of minors, or healthcare providers are required to file transferring out-of-state immunization records when a patient relocates or enrolls in a new school in a different state.
How to fill out transferring out-of-state immunization records?
To fill out transferring out-of-state immunization records, one should gather the individual's vaccination history, complete any required forms from the receiving state’s immunization registry, and include details such as the type of vaccines administered, dates of administration, and healthcare provider information.
What is the purpose of transferring out-of-state immunization records?
The purpose of transferring out-of-state immunization records is to ensure that healthcare providers in the new state have access to an individual's complete vaccination history, which is important for continuity of care and public health.
What information must be reported on transferring out-of-state immunization records?
Information that must be reported includes the individual's name, date of birth, vaccine types, dates administered, and the name and contact information of the healthcare provider who administered the vaccinations.
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