Get This Record Is Part Ofthe Student's Permanent School Record (cumulative Folder) As Defined In

Completing the This Record Is Part Of the Student's Permanent School Record is essential for proper enrollment in schools and early childhood programs. This guide provides a detailed, step-by-step approach to filling out the form accurately online.

Follow the steps to complete the immunization record effectively.

1. Click ‘Get Form’ button to access the form and open it in your editor.
2. Begin by entering the student's name in the designated field. Make sure to double-check the spelling for accuracy.
3. Select the appropriate gender option for the student by marking either 'Male' or 'Female'.
4. Input the date of birth in the specified format, ensuring it is correct.
5. The signature of the parent or guardian is required. Use the provided space to sign.
6. Enter the name of the parent or guardian in the corresponding field.
7. Fill in the city and mailing address where the family resides.
8. Indicate if the child has health insurance by selecting 'YES' or 'NO'.
9. Provide a telephone number for contact purposes.
10. Specify the zip code for the address listed.
11. If there is no health insurance, select 'YES' or 'NO' to indicate if contact about health coverage for children is desired.
12. Record the dates of the vaccines in the designated columns sequentially, ensuring to include month, day, and year.
13. For each vaccine listed, make sure to enter the correct corresponding date it was administered.
14. Mark the appropriate box if an exemption for medical, religious, or personal reasons is requested and provide justifications if needed.
15. Sign the form again under the section for a parent or guardian if the child has had chickenpox, confirming this information.
16. Finally, review all filled sections for accuracy, save your changes, and ensure to either download, print, or share the form as needed.

Complete your documents online to ensure a smooth enrollment process.