Get Epi 12b Grades Kindergarten 12th (pdf) - Hawaii Department Of ...

This guide provides clear instructions on how to accurately fill out the EPI 12B form for grades Kindergarten to 12th, as required by the Hawaii Department of Health. It is essential for ensuring that all immunization records are correctly documented for public and private schools.

Follow the steps to complete the form online.

1. Click the ‘Get Form’ button to access the EPI 12B form and open it in your PDF editor.
2. Begin by entering the school information. Fill out the school name, mailing address, and location address. Ensure all fields are complete to facilitate accurate reporting.
3. For enrollment details, specify whether the school has a pre-k program. If yes, complete the associated enrollment sections for kindergarten and other grades.
4. In the enrollment information section, list the total enrollment number and provide the necessary fax number if applicable.
5. Complete section #2 by confirming whether all enrollees meet immunization requirements. If any students are missing required immunizations, move to section #3.
6. List the names of students missing required immunizations in section #3. For each student, input their date of birth and entry date.
7. Mark an (X) in the appropriate column for any missing vaccine doses from the list provided, including exemptions for religious or medical reasons.
8. After completing the form, ensure you read the instructions on the reverse side for any additional guidance. Once finalized, you can save your changes, download the form, print it, or share it as necessary.

Complete the EPI 12B Grades Kindergarten 12th form online today to ensure accurate immunization reporting.