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3774 Walker Road Windsor, Ontario N8W 3S8 T: (519) 9678592 F: (519) 9678595Child and Pediatric Health History Form Please complete the following as completely as possible. If you need assistance,
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How to fill out your childs immunization record
How to fill out your childs immunization record
01
Gather all of your child's immunization records from their doctors or previous schools.
02
Carefully review the immunization record to make sure all required vaccines are documented.
03
Fill out any missing information such as dates of vaccinations, vaccine names, and healthcare provider information.
04
Make sure the record is signed and dated by a healthcare provider to make it official.
05
Keep the record in a safe and easily accessible place for future reference.
Who needs your childs immunization record?
01
Schools may require your child's immunization record for enrollment.
02
Healthcare providers may request the record for routine check-ups and appointments.
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What is your child's immunization record?
Your child's immunization record is an official document that tracks all vaccines your child has received, including dates and types of immunizations administered.
Who is required to file your child's immunization record?
Typically, parents or guardians are required to file their child's immunization record with the school or daycare facility the child is attending.
How to fill out your child's immunization record?
To fill out your child's immunization record, you should provide accurate dates of each vaccination, the type of vaccine received, and the name of the healthcare provider who administered it.
What is the purpose of your child's immunization record?
The purpose of your child's immunization record is to ensure proper tracking of vaccines given, required for school entry, and to help public health officials prevent outbreaks of vaccine-preventable diseases.
What information must be reported on your child's immunization record?
Your child's immunization record must report the child's full name, date of birth, vaccination dates, vaccine types, and the name of the administering healthcare provider.
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