Get Child Care Certificate Of Immunization Hes-101

The Child Care Certificate Of Immunization HES-101 is a vital document required for individuals attending school or child care in Montana. Completing this form accurately ensures compliance with immunization laws and helps facilitate a safe environment for all participants.

Follow the steps to complete the form online effectively.

1. Begin by accessing the form through the ‘Get Form’ button to obtain the document in your chosen online editor.
2. In Section I, clearly print the child or student’s name, birth date, parent or guardian’s name, address, sex, primary provider, city, and contact phone numbers including home and work.
3. Proceed to Section II to record the immunization history. Only a school, child care, or medical professional should fill this out. Ensure to document the month, day, and year for each required vaccine dose.
4. Verify that all required vaccines are included in Section II: Diphtheria/Tetanus/Pertussis (DTaP), Haemophilus Influenzae Type B (Hib), Measles/Mumps/Rubella (MMR), Polio, Varicella, Hepatitis B, and Pneumococcal Conjugate vaccine (PCV13). Note that additional vaccines may apply as per the advisory recommendations.
5. For immunizations filled out by a health department or healthcare provider, ensure appropriate signatories are present in the designated signature areas, confirming the immunization history to the best of their knowledge.
6. If applicable, ensure that any exemptions or conditional attendance documentation is completed and attached as required by Section III of the form.
7. Once all sections are filled out accurately, review the document for any errors or omissions.
8. Finally, save the changes, and choose to download, print, or share the completed form as needed to submit it to the relevant educational or child care institution.

Complete your Child Care Certificate Of Immunization HES-101 online today to ensure your child meets all requirements.