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MANITOBA HEALTH AND HEALTHY LIVINGMIMS: IMMUNIZATION TABLE LISTINGTo Supervisor/Data ControlComputer Services3047300 Carlton St. Winnipeg, ManitobaR3B 3M9FAX: 9430972 Date:___JOB: A4MILSTIPROGRAM:A4MI014
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How to fill out your immunization record matters

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How to fill out your immunization record matters

01
Step 1: Obtain a copy of the immunization record form from your healthcare provider or download it online.
02
Step 2: Fill in your personal information, such as your name, date of birth, and contact details, at the top of the form.
03
Step 3: Review your medical history and gather any relevant documents or records that contain information about your past immunizations.
04
Step 4: Start with the most recent immunization and enter the date it was administered, the name of the vaccine, the dosage, and the route of administration.
05
Step 5: Repeat step 4 for each immunization you have received, working backwards in chronological order.
06
Step 6: If you cannot remember certain details about a past immunization, contact your healthcare provider for assistance.
07
Step 7: Double-check all the information you have entered to ensure accuracy and completeness.
08
Step 8: Sign and date the form at the bottom to certify that the information provided is true and accurate.
09
Step 9: Make a photocopy of the completed form for your own records.
10
Step 10: Submit the original form to the appropriate organization or institution that requires your immunization record.

Who needs your immunization record matters?

01
Students: Most schools and universities require students to provide proof of immunizations to enroll or attend classes.
02
Healthcare Workers: Professionals in the healthcare field are often required to maintain up-to-date immunization records to protect themselves and their patients.
03
Travelers: Some countries may require travelers to provide proof of certain immunizations before entering or obtaining a visa.
04
Employers: Certain job positions, especially in healthcare or childcare, may require applicants or employees to provide immunization records.
05
Immigrants: Individuals immigrating to certain countries may need to provide their immunization records as part of the immigration process.
06
Parents/Guardians: Parents or guardians of children may need to provide their child's immunization record to schools, childcare facilities, or other organizations.

What is Your Immunization Record Matters - Health Form?

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Your immunization record is a documented history of vaccinations you have received. It is important for tracking your immunity against various diseases and ensuring compliance with health regulations.
Individuals who receive vaccinations are typically required to file their immunization records. This includes students entering school, healthcare professionals, and certain employers or organizations that mandate vaccination.
To fill out your immunization record, you should provide information such as your name, date of birth, the vaccines received, and the dates they were administered. It is essential to obtain this information from your healthcare provider or vaccination clinic.
The purpose of your immunization record is to provide proof of vaccinations received, help prevent the spread of infectious diseases, and ensure you are protected against preventable illnesses.
Your immunization record must report your personal details, the types of vaccines received, the administration dates, and the healthcare provider's details.
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