Get Certificate Of Immunization Status Form - Heritage University

This guide provides clear instructions for filling out the Certificate Of Immunization Status Form from Heritage University online. By following these steps, users can efficiently complete the form and ensure it is properly submitted for school or child care requirements.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the form and open it in your document editor.
2. In the top section, enter the child’s last name, first name, middle initial, birthdate (in mm/dd/yyyy format), and sex.
3. For each vaccine received, write the vaccine name under the ‘Vaccine’ column and fill in the corresponding dates in the ‘Month,’ ‘Day,’ and ‘Year’ columns.
4. If a combination vaccine was administered, follow the Reference Guide to input each vaccine correctly.
5. If the child has had chickenpox, select one of the four provided options for verification based on your health care provider's documentation or the Immunization Registry.
6. If applicable, have your health care provider fill out the section for Documentation of Disease Immunity, ensuring signed lab reports are attached.
7. Sign and date the form in the indicated upper right box, then save changes to your document.
8. Once completed, you can download, print, or share the form as required for submission.

Complete your Certificate Of Immunization Status Form online today!