Get Immunization (vaccination) Information Form... - Extrasteps

Completing the Immunization (Vaccination) Information Form is a crucial step in ensuring your child's health records are accurate and up to date. This guide will provide clear and supportive instructions to help you navigate each section of the form seamlessly, ensuring compliance with childcare requirements.

Follow the steps to complete the form online:

1. Click the ‘Get Form’ button to access the Immunization Information Form. This will allow you to open the form in your preferred online editor.
2. Provide your childcare facility's name at the top of Part A. This ensures your form is directed to the correct location.
3. Fill in your child’s information clearly, including their surname, given name, preferred name, place of birth, birthdate, and personal health number. Ensure all details are accurate.
4. List your home address and postal code. This section is important for correspondence regarding your child’s health.
5. Enter the names of the parents or guardians and their contact numbers. Include daytime phone numbers for easy communication.
6. In Part B, answer the question about your child’s chickenpox disease status by checking the applicable box. This information is crucial for vaccine recommendations.
7. Attach a photocopy of your child's vaccination record to the form as instructed. Ensure your child’s name and date of birth appear on each page of the attachment.
8. Review all information entered to confirm completeness and accuracy before finalizing your form.
9. Once all sections are filled out correctly, proceed to save your changes and download the completed form. You may opt to print or share the form as needed.

Take the next step in your child's health management by completing the Immunization Information Form online today.