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Get CA CDPH 286 2014-2023

box. A. Fill in date and your signature as the staff member who reviewed and transcribed the immunization record presented by the parent or guardian. Check which type of record was presented. B. If the child has met all immunization requirements, check box A and write in date. C. If the child has not met all requirements, check box B. Child can be admitted only if up-to-date, e.g., no immunizations due currently. The child must be followed up as indicated in the ‘‘Guide to Immunization Requ.

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