Follow the steps to fill out the WY DoH Conditional Enrollment Form online

1. Press the ‘Get Form’ button to access the Conditional Enrollment Form and open it for editing.
2. In Section 1, enter the name of the school or child caring facility in the designated space. Next, provide the child's name and date of birth.
3. In Section 1, identify the vaccines that are missing or invalid. Check all applicable boxes next to the corresponding vaccines.
4. For any vaccines listed, specify the doses that are missing. Use the checkboxes to indicate the appropriate dose requirements for each vaccine.
5. Proceed to Section 2, which must be completed by a physician or their representative. Enter the disease for which vaccination or serologic testing is scheduled. If applicable, include the due date for vaccination.
6. Also, in Section 2, provide the appointment date for vaccination or testing.
7. In Section 2, the physician or designee must sign and date the form, certifying that the child is in the process of receiving the indicated immunizations.
8. Move to Section 3, where the child's parent or guardian must acknowledge their understanding of the conditional enrollment policy. They must provide their printed name, sign the form, and include the date.
9. Finally, review the completed form. Ensure all sections are filled out accurately, then save changes, download, print, or share the form as needed.

Complete the WY DoH Conditional Enrollment Form online for your child's enrollment.