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  • Certificate Of Immunization Status Form - Wix.com

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Certificate of Immunization Status (CIS) DOH 348-013 January 2010 Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Registry. Child s Last.

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How to fill out the Certificate Of Immunization Status Form - Wix.com online

Filling out the Certificate Of Immunization Status Form is a crucial step in documenting your child's vaccination history. This guide provides clear, step-by-step instructions for completing the form accurately and efficiently, ensuring you meet any necessary requirements.

Follow the steps to fill out your certificate with ease.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your child's last name, first name, middle initial, birthdate in mm/dd/yyyy format, and sex in the designated fields.
  3. Next, list the vaccines your child has received under the 'Vaccine' column. For each vaccine, record the date of each dose in the appropriate columns for month, day, and year.
  4. For combination vaccines, refer to the reference guide to correctly note each vaccine type in the correct columns, ensuring accurate documentation.
  5. If your child has had chickenpox disease instead of the vaccine, choose one of the four options provided to verify this history, and fill in the necessary details.
  6. If applicable, have your health care provider fill in the documentation of disease immunity, marking the relevant diseases and providing a signed lab report if necessary.
  7. Make sure to sign and date the form in the specified area near the top right before submitting the document.
  8. After completion, you have the option to save changes, download, print, or share the form as required.

Complete your documents online today to ensure your child's vaccination status is up to date.

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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
Help Portal
Legal Resources
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