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  • F-04020l Rev 07112 Student Immunization Record - Brookfieldacademy

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DEPARTMENTOF HEALTHSERVICES Divisionof Public Health F-04020L(Rev.07112) STATEOF WISCONSIN 252.04 and 120J2 (16) Wis. Stats. RECORD STUDENTIMMUNIZATION INSTRUCTIONS TO PARENT: COMPLETEAND RETURNTO.

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Wisconsin Immunization Registry (WIR) is an online database that tracks vaccine records for Wisconsin children and adults. WIR is an important tool that: Helps ensure children and adults receive vaccines on time. Reduces the time and money it takes you to get old vaccine records.

This may have happened for a number of reasons: The person's vaccine record may not have been recorded in WIR by a doctor's office. The person's vaccine record is in WIR, but the searchable information (for example, the social security number, date of birth, or chart number) may be missing or wrong.

Click on the 'Public Immunization Record Access' hyperlink from the login screen for the Wisconsin Immunization Registry web site. The Public Access Search screen displays. Enter the first name, last name, and date of birth for the person whose record you are searching for. These are required fields.

Click on the 'Public Immunization Record Access' hyperlink from the login screen for the Wisconsin Immunization Registry web site. The Public Access Search screen displays. Enter the first name, last name, and date of birth for the person whose record you are searching for. These are required fields.

Here are the steps on how to fill out the immunization form for Manipal: Download the immunization form from the Manipal website. Read the instructions carefully before filling out the form. Enter your personal information, including your name, date of birth, address, and contact information.

Medical waivers are available for those children who are not medically able to be vaccinated. A note from your child's health care provider is sufficient. Failure to meet Wisconsin's immunization requirements is AGAINST THE LAW.

Wisconsin's statewide, population-based IIS, the Wisconsin Immunization Registry (WIR), was established in 2000 by the Wisconsin Divisions of Public Health (WDPH) and Health Care Access and Accountability.

School Immunization Requirements Age/GradeNumber of DosesPre-K (2 yrs through 4 yrs)4DTP/DTaP/DT; 3Polio; 3HepB; 1MMR; 1 VarGrades K through 54DTP/DTap/DT/Td; 4 Polio; 3 HepB; 2 VarGrades 6 through 124DTP/DTaP/DT/Td; 1Tdap; 4 Polio; 3 HepB; 2 MMR; 2 Var

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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