Get Ky Epid-230c 2010-2026

The KY EPID-230C is a certificate of religious exemption for immunizations required for school entry in the Commonwealth of Kentucky. This guide provides step-by-step instructions to help you complete the form accurately and effectively.

Follow the steps to successfully complete the KY EPID-230C online.

1. Click the ‘Get Form’ button to access the KY EPID-230C document and open it in a user-friendly editor.
2. Begin by entering the name of the child in the designated fields. Provide the last name, first name, and middle name as required.
3. Next, input the birthdate of the child in the appropriate section. Ensure the date is formatted correctly.
4. Fill in the name of the parent or guardian in the given field. Clearly indicate their full name as it appears on legal documents.
5. Provide the complete address of the parent or guardian, including street, city, state, and zip code. Double-check for accuracy.
6. In the section indicating the religious exemption, ensure that it is clearly stated that the child is granted an exemption from required immunizations.
7. Obtain the required signature from an authorized healthcare provider, such as a physician, APRN, PA, pharmacist, LHD administrator, or nurse designee, and include the date of signing.
8. Write the name of the office or licensed healthcare facility in the specified field to validate the certificate.
9. Once all sections are completed, review the form for any errors. Make necessary corrections to ensure all information is accurate.
10. Finally, save changes to the form, and choose to download, print, or share the completed KY EPID-230C as needed.

Complete your KY EPID-230C form online today for a smooth school enrollment process.