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MONTGOMERY TOWNSHIP SCHOOLSSkillman, NJ 08558 Vaccination Record*
*Must be completed by healthcare provider with signature and stamp belowChilds Name: ___ Date of Birth (M/D/BY): ___
Gender (circle):MaleFemale
Vaccine
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How to fill out my vaccine record
How to fill out my vaccine record
01
Obtain a copy of your vaccine record from your healthcare provider or through an online portal
02
Fill in your personal information such as name, date of birth, and contact information
03
Record the dates of each vaccine dose received, including the type of vaccine and dose number
04
Make sure to include the name and location of the healthcare provider or clinic where the vaccine was administered
05
Keep the record in a safe and easily accessible place for future reference
Who needs my vaccine record?
01
Employers may require proof of vaccination for certain jobs
02
Schools and universities may request vaccine records for enrollment
03
Travelers may need to show vaccine records for entry into certain countries or when boarding flights
04
Healthcare providers may use vaccine records for medical history and treatment purposes
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What is my vaccine record?
Your vaccine record is a documentation of all the vaccines you have received.
Who is required to file my vaccine record?
Healthcare providers are required to file your vaccine record.
How to fill out my vaccine record?
You can fill out your vaccine record by providing information about the vaccines you have received, including the date and type of vaccine.
What is the purpose of my vaccine record?
The purpose of your vaccine record is to keep track of the vaccines you have received and ensure you are up to date with immunizations.
What information must be reported on my vaccine record?
Your vaccine record must include information about the vaccines you have received, such as the date and type of vaccine.
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