Get the free Certificate of Immunization Status form - skitsap wednet

Submit Certificate of Immunization Status (CIS) DOH 348-013 January 2010 Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Registry. Child

How to fill out certificate of immunization status

How to fill out a certificate of immunization status:

1. Obtain the certificate of immunization status form from your local health department or healthcare provider.
2. Fill in your personal information, including your full name, date of birth, and contact information.
3. Provide details about your immunization history, such as the specific vaccines you have received and the dates they were administered. Include information on vaccinations for diseases such as measles, mumps, rubella, hepatitis, polio, tetanus, diphtheria, and pertussis.
4. If you have received any vaccinations as an adult, make sure to include that information as well.
5. Sign and date the certificate to verify that the information provided is accurate.
6. Submit the completed certificate to the appropriate organization or institution that requires it, such as your school, college, or employer.

Who needs a certificate of immunization status?

1. Students: Many schools and educational institutions require students to provide a certificate of immunization status as proof that they are up-to-date on their vaccinations. This helps ensure a safe and healthy environment for all students and staff members.
2. Healthcare Professionals: Healthcare workers, including doctors, nurses, and other medical professionals, may need to provide a certificate of immunization status as part of the employment or licensing requirements. This helps protect patients and healthcare facilities from the spread of vaccine-preventable diseases.
3. Travelers: Some countries require travelers to provide a certificate of immunization status to prove that they have been vaccinated against certain diseases before entering the country. This is especially common for travelers visiting regions where there may be a higher risk of contagious diseases.
4. Employees: Certain professions or job positions may require employees to provide a certificate of immunization status. This is often the case in industries where there is a higher risk of exposure to infectious diseases, such as healthcare, childcare, or food service.
5. Volunteers: Organizations that rely on volunteers, such as shelters, charities, or disaster relief agencies, may request a certificate of immunization status to ensure the safety of their volunteers and the individuals they serve.

Overall, a certificate of immunization status is typically required by educational institutions, employers, regulatory bodies, and some countries to ensure that individuals are protected against vaccine-preventable diseases and promote public health.

For pdfFiller’s FAQs

What is certificate of immunization status?

The certificate of immunization status is a document that verifies an individual's immunization history.

Who is required to file certificate of immunization status?

All individuals, including students, healthcare workers, and travelers, are required to file a certificate of immunization status.

How to fill out certificate of immunization status?

The certificate of immunization status can be filled out by providing information on the individual's vaccination records, including dates and types of vaccines received.

What is the purpose of certificate of immunization status?

The purpose of the certificate of immunization status is to ensure that individuals are up to date on their vaccinations to prevent the spread of vaccine-preventable diseases.

What information must be reported on certificate of immunization status?

The certificate of immunization status must include information on the individual's name, date of birth, healthcare provider, and vaccination records.

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