Immunization Record Card - Page 2

blue card forms
blue card forms
Emergency information and immunization record card child's name: street city state date enrolled: updated: date disenrolled: male female zip home address: home phone: mother or guardian name: home address: street city
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04020l form
04020l form
Department of health services division of public health f04020l (rev. 06/2017)state of wisconsin wis. stat. 252.04 and 120.12 (16)student immunization record instructions to parent: complete and return to school within 30 days after admission....
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california immunization card printable form
california immunization card printable form
California school immunization record. this record must be completed by school and child care personnel from an immunization record provided by
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immunization card form
immunization card form
Immunization signature card client number last name first name mid-initial birthdate (mo/day/year) male name of parent or legal guardian female mother's maiden name and date of birth mailing address city state zip telephone () the following...
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- colorado
- colorado
When do children and teens need vaccinations? please note: your child may need additional vaccines and possibly, fewer doses of the vaccines listed below depending on the type of vaccines that your healthcare provider uses. talk to your healthcare...
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washington state immunization record form
washington state immunization record form
Every age. every vaccination. washington state immunization information system information sharing agreement for head start and/or ec eap grantee agencies with a healthcare provider on staff (view-only) i. this is an agreement (agreement) between...
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immunizations records california 2002 form
immunizations records california 2002 form
California school immunization record this record is part of the student's permanent record (cumulative folder) as defined in section 49068 of the education code and shall transfer with that record. local health departments shall have access to...
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immunization record card 2011 form
immunization record card 2011 form
Vaccine administration record for children and teens patient name: birthdate: chart number: (page 1 of 2) before administering any vaccines, give copies of all pertinent vaccine information statements (kiss) to the child's parent or legal...
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printable immunization record forms 2011
printable immunization record forms 2011
(page 1 of 2) vaccine administration record for adults patient name: birthdate: chart number: before administering any vaccines, give the patient copies of all pertinent vaccine information statements (kiss) and make sure he/she understands the...
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What is Immunization Record Card?

The Immunization Record Card is a document that tracks an individual's immunization history. It serves as a valuable record of the vaccinations received, including the type of vaccine, date administered, and the healthcare provider who administered it. This record card is essential for ensuring that a person is up to date on necessary immunizations and can be vital for school enrollment, traveling, and medical emergencies.

What are the types of Immunization Record Card?

There are several types of Immunization Record Cards available depending on the location and purpose. The most common types include:

The Child Immunization Card: This card is specifically designed to track the immunization history of infants, toddlers, and young children. It records important vaccines received during early childhood.
The Adult Immunization Card: This card focuses on tracking the immunization history of adults and includes vaccines that are recommended throughout adulthood, such as flu shots, tetanus boosters, and hepatitis vaccines.
The International Certificate of Vaccination: Also known as the Yellow Card, this type of record card is used for international travel. It includes important vaccinations required by specific countries and serves as proof of immunization when crossing borders.

How to complete Immunization Record Card

Completing an Immunization Record Card is a straightforward process that ensures accurate and up-to-date recording of vaccinations. Follow these steps:

01
Start by obtaining an official Immunization Record Card from a healthcare provider or download a printable template from pdfFiller.
02
Fill in personal information: Write your full name, date of birth, gender, and contact information.
03
Record each vaccination: Include the vaccine name, manufacturer, lot number, date received, and the healthcare provider who administered it. If available, add any additional information like the vaccine's expiration date.
04
Keep the card in a safe place: Store the card in a secure location, preferably with other important medical documents. Make a copy or take a picture of the card for backup purposes.
05
Update the card regularly: Whenever you receive a new vaccination, update the card accordingly. It is essential to keep the card current and accurate.

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Video Tutorial How to Fill Out Immunization Record Card

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