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How to fill out the Dhec 1123 Form online
Filling out the Dhec 1123 Form online is a straightforward process that assists in documenting the special exemption of students from vaccination requirements. This guide provides a clear, step-by-step approach to ensure you complete the form accurately and efficiently.
Follow the steps to successfully fill out the Dhec 1123 Form online.
- Click ‘Get Form’ button to access the Dhec 1123 Form and open it for editing.
- In Section I – Pupil Information, enter the pupil's last name, followed by their first name, and middle initial. Ensure all names are spelled correctly.
- Provide the parent's name(s). If the pupil lives with a guardian, input the guardian's name instead.
- Input the complete mailing address, including street, city, state, and zip code, for the parent(s) or guardian.
- Enter the home telephone number of the parent(s) or guardian listed.
- Section II is informational and does not require any input from you.
- In Section III, identify the reason for issuing the Certificate of Special Exemption by checking the appropriate box for either transfer or non-transfer students.
- School officials must sign the form in the designated area, providing their contact telephone number and the date the certificate is issued.
- Review all entries for accuracy. Once confirmed, save the changes, and download or print the completed form for your records.
Complete the Dhec 1123 Form online today to ensure compliance with school immunization requirements.
In Virginia, to secure a religious exemption for vaccines, you can use the Dhec 1123 Form. In this form, you will need to explain your religious beliefs regarding vaccinations. Submit the completed form to the appropriate school or health authority. Following up after submission helps ensure your request is processed properly.
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