Get Wi Dhs F-04002 2021-2026

The WI DHS F-04002 form is essential for schools in Wisconsin to report student immunization compliance to local health departments. This guide will provide clear and supportive instructions on how to complete the form online.

Follow the steps to accurately fill out the form.

1. Click the ‘Get Form’ button to obtain the form and open it for completion.
2. In Section A, fill out the school’s information, including the Local Education Agency (LEA) code and the DPI School Code. Ensure you accurately report the grades enrolled at the school.
3. In Section B, categorize the number of students based on immunization compliance for each vaccine. Use the specific categories (e.g., meets minimum requirements, in process) for accurate reporting. Remember to enter zeros where applicable.
4. Section C requires you to report the total number of students meeting specific criteria such as those with waivers or those with no immunizations. Ensure that the sums are accurate and align with your data.
5. In Section D, list the number of students who have specific types of waivers, ensuring that each metric is clear and accurate.
6. After completing all sections, review the form for accuracy. Make any necessary corrections and ensure all data is complete before submitting.
7. Finally, you can save changes, download, print, or share the form as needed.

Complete your forms online today to ensure timely compliance with health reporting requirements.