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DEPARTMENT OF HEALTH SERVICES Division of Public Health F44192 (Rev. 12/2017)STATE OF WISCONSIN Wis. Stat. 252.04CHILD CARE IMMUNIZATION RECORDCOMPLETE AND RETURN TO CHILD CARE CENTER. State law requires
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How to fill out daycare immunization formpdf
How to fill out daycare immunization formpdf
01
Obtain the daycare immunization formpdf from the daycare center or download it from their website.
02
Fill out the child's personal information, including their name, date of birth, and address.
03
Provide details of the child's immunization history, including the type of vaccines received and the dates they were administered.
04
Sign and date the form to verify the accuracy of the information provided.
05
Submit the completed daycare immunization formpdf to the daycare center for their records.
Who needs daycare immunization formpdf?
01
Children who are enrolled in daycare or preschool settings typically need to have a completed daycare immunization formpdf on file.
02
This form is necessary to ensure that children attending the daycare center are up to date with their vaccinations and protected against vaccine-preventable diseases.
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What is daycare immunization formpdf?
The daycare immunization form is a document that records the vaccination history of a child, required for enrollment in daycare facilities.
Who is required to file daycare immunization formpdf?
Parents or guardians of children being enrolled in a daycare facility are required to file the daycare immunization form.
How to fill out daycare immunization formpdf?
To fill out the daycare immunization form, provide the child's personal information, list all vaccinations received along with dates, and sign the form.
What is the purpose of daycare immunization formpdf?
The purpose of the daycare immunization form is to ensure that children enrolled in daycare are vaccinated against communicable diseases, providing a safer environment.
What information must be reported on daycare immunization formpdf?
The form must report the child's name, date of birth, vaccination history, including types of vaccines and dates administered, and the name of the healthcare provider.
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