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KS Certificate of Immunization (KCI) 2013 free printable template

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Exemption shall be validated annually by physician completion of PCI Form ... 4-week minimum interval between first 3 doses; 6-month interval required between ...
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KS Certificate of Immunization (KCI) Form Versions

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KS Certificate of Immunization (KCI) 2019
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KS Certificate of Immunization (KCI) 2013
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How to fill out KS Certificate of Immunization KCI

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How to fill out KS Certificate of Immunization (KCI)

01
Obtain the KS Certificate of Immunization (KCI) form from your healthcare provider or school.
02
Provide your personal information including your name, date of birth, and contact information.
03
List all immunizations received, including dates for each vaccine.
04
Ensure that a healthcare provider signs and dates the form to verify the information.
05
Submit the completed KCI to your school or the relevant authority.

Who needs KS Certificate of Immunization (KCI)?

01
Children entering school for the first time.
02
Students transferring from another state or school.
03
Individuals enrolling in daycare or preschool programs.
04
Residents of Kansas who are required to provide proof of immunization for job or travel purposes.
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The KS Certificate of Immunization (KCI) is an official document that records a person's immunization history, including vaccinations received for various diseases.
Individuals enrolling in schools, childcare facilities, or certain public health programs in Kansas are required to file the KS Certificate of Immunization (KCI).
To fill out the KS Certificate of Immunization, provide personal information such as the individual's name, date of birth, and a complete record of all vaccinations, including dates and types of vaccines administered.
The purpose of the KS Certificate of Immunization (KCI) is to ensure that individuals are adequately vaccinated to protect public health and safety, particularly in school and childcare settings.
The KS Certificate of Immunization must report information such as the individual's name, date of birth, vaccination dates, vaccine types, and the signature of the healthcare provider who administered the vaccines.
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Related Links

Kansas Department of Health and Environment
A Kansas Certificate of. Immunizations (KCI) may be substituted for this form and attached to the completed Medical Record. Child's Name: Date of Birth ...
HBHA Immunization Policy
KANSAS CERTIFICATE OF IMMUNIZATIONS (KCI). This record is ... shall be validated annually by physician completion of KCI Form B and attachment to the KCI.
I. K-12 Kansas statutes impose vaccination and other health ...
Nov 12, 2021 — Annual medical exemptions shall be documented on this form and attached to the student's. Kansas Certificate of Immunizations (KCI) form.

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