Get State Of Montana Certificate Of Immunization - Dphhs Mt

Completing the State of Montana Certificate of Immunization is essential for all individuals attending school or child care facilities. This guide provides clear instructions on how to fill out the form accurately and efficiently.

Follow the steps to complete the Certificate of Immunization form.

1. Press the ‘Get Form’ button to access the Certificate of Immunization form. This action will allow you to open the document for entry.
2. In Section I, please print the child's name, birth date, and the name of the parent or guardian. Provide the residential address, including city and telephone numbers for home and work. Ensure this information is clear and legible.
3. Move to Section II and provide the immunization history. This section must be completed by authorized personnel such as a school, child care, or medical provider. Enter the month, day, and year of each administered vaccine dose for the required vaccinations.
4. Check the appropriate boxes that indicate whether the vaccines are required for child care (CC) or school (SR). Note that a booster dose of Tdap is required before entering 7th grade.
5. If there is any documentation regarding the disease for varicella, please check the designated box in Section II. This must also be included for documentation of other vaccines as specified.
6. In Section III, if applicable, school or child care officials must sign and date to certify that the information has been accurately transcribed from supporting documentation. This includes details provided for conditional attendance where applicable.
7. Review all entered information for accuracy and completeness. Make any necessary edits to ensure the form is correct before finalization.
8. Once all sections are complete, save your changes. You may then download, print, or share the completed Certificate of Immunization as needed.

Complete your state of Montana Certificate of Immunization online today to ensure compliance with school and child care requirements.