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  • Montana Department Of Public Health Annual Immunization Status Report For Schools Form

Get Montana Department Of Public Health Annual Immunization Status Report For Schools Form

Montana Department of Public Health Human Services ANNUAL IMMUNIZATION STATUS REPORT OF PUPILS ATTENDING MONTANA PUBLIC AND PRIVATE SCHOOLS Name of School Submitted By Address Title Zip Code City Phone Number Date report completed Email of person submitting report County District Private School Public School PURPOSE OF FORM This is a worksheet to help schools identify all pupils attending who are not fully immunized for each disease category. Reporting of each pupil s immunization status regarding these diseases is required by law Sec* 20-5-408 MCA and administrative rule 37. 114. 720 ARM. If a student has a religious or medical exemption that counts as having an immunization record GRADE NUMBER OF PUPILS ENROLLED CONDITIONALLY ATTENDING K PHHS-106 REVISED 9/9/2013 PUPILS WITH MEDICAL EXEMPTION RELIGIOUS NO IMMUNIZATION RECORD WITH 2 DOSES OF MMR WITH 3 IPV/OPV OF WITH 4 DTP/DTAP Td/Tdap Booster. Reporting of each pupil s immunization status regarding these diseases is required by law ....

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How to fill out the Montana Department Of Public Health Annual Immunization Status Report For Schools Form online

Completing the Montana Department Of Public Health Annual Immunization Status Report For Schools Form is a vital process for schools to ensure that all pupils are adequately immunized. This guide provides step-by-step instructions for filling out the form online to assist users in submitting the report efficiently and accurately.

Follow the steps to successfully complete the immunization status report.

  1. Press the ‘Get Form’ button to access the form and open it in the designated editor.
  2. Enter the name of the school in the designated field. This identifies the institution for which you are submitting the report.
  3. Fill in the 'Submitted By' section with your name so that the report is attributed to an individual responsible for its completion.
  4. Provide the address of the school, including the street, city, state, zip code, and any relevant contact details.
  5. Indicate your title in the designated field to authenticate your position within the school.
  6. Complete the phone number and email address fields for follow-up communications regarding the report.
  7. Select the appropriate category for the school (public or private) by checking the corresponding box.
  8. List the total number of pupils enrolled in each grade along with the corresponding number of pupils conditionally attending for the current school year.
  9. Indicate the number of pupils with medical exemptions and religious exemptions by filling in those sections based on the information you have gathered.
  10. Report the numbers for pupils with no immunization records, as well as those who have received the required doses of MMR, IPV/OPV, DTP/DTAP, and Td/Tdap boosters.
  11. After completing all sections, review the entire form for accuracy.
  12. Once verified, you can save your changes, download the completed form, print it for physical documentation, or share it as needed.

Complete your Montana Department Of Public Health Annual Immunization Status Report For Schools Form online today.

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Go to the Med+Proctor website or search for “Immunization Compliance” in One. IU to create an account and upload proof of compliance. Once you create a Med+Proctor account, you will have two options for submitting your documentation: Pay a one-time fee of $10 for lifetime access to any immunization records you upload.

Returning Students in a Health-Related Program Current students can print out their immunization history by using the patient portal. Former students must complete the Authorization to Release or Obtain Medical Records form and return it to Student Health Services via fax or mail.

How to Submit COVID-19 Documentation For COVID-19 vaccination records and medical exemption documentation: use the SHCS Immunization Submissions form. For religious accommodations/exemptions: use the Religious Exemption form (for COVID-19 vaccination only). Please note that you must include a personal statement.

How and where do I submit immunization records? You may submit a copy of your immunization records: Via fax: to 305-348-3336 or 305-919-5312. Via email: scanned documents to immune@fiu.edu (subject: Panther ID#)

Log into the Student Self-Service Portal and proceed to the Enter Dates screen under Immunization. Follow the page instructions to enter your vaccine and/or titer dates. Upload the immunization form and supporting lab reports.

Where do I upload photos of my immunization records? All photos or files can be submitted on The Ashe Center Patient Portal by clicking Medical Clearances, then selecting Immunization Upload, then Update.

1 dose of Measles, Mumps, and Rubella (MMR) given on or after the 1st birthday and a 2nd dose prior to entry of Kindergarten. A dose of Tdap is preferred to provide protection against whooping cough, also known as pertussis. Tdap is not a requirement. Does the State of Montana allow the 4 day grace period in schools?

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232