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Get Wi Dhs F-04002 2008-2025
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How to fill out the WI DHS F-04002 online
Filling out the WI DHS F-04002 form is essential for reporting student immunization compliance to local health departments in Wisconsin. This guide provides clear, step-by-step instructions tailored for users of all backgrounds, helping you navigate the process with ease.
Follow the steps to complete the form effectively.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- In Section A, provide the contact information for your school, including the DPI LEA (District) Code and DPI School Code. Ensure you obtain these codes correctly using the links provided.
- List the grades that are enrolled at your school in Section A, specifying each grade from your institution.
- In Section B, enter the number of students in each compliance category for Kindergarten in Column A and for all students enrolled at the school in Column B.
- For each category in Section B, input the appropriate number of students falling into rows 1 through 7, ensuring not to list any student in more than one category.
- In Section C, row 9, report the number of students who have received no immunizations and possess waivers for all vaccines.
- Review all sections to confirm the accuracy of the entered data, ensuring it aligns with student records.
- Once verified, proceed to save any changes made to the form, then download, print, or share it as necessary.
Complete your documents online to ensure compliance and contribute to public health.
Students should receive the Tdap (tetanus, diphtheria and acellular pertussis) vaccine before the start of 7th grade rather than 6th grade. Students who received one dose of Tdap prior to the start of 6th grade under the previous requirement are compliant and do not need to receive an additional dose of Tdap.
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