We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Social Forms
  • Kansas Social Forms
  • Ks Certificate Of Immunization (kci) 2013

Get Ks Certificate Of Immunization (kci) 2013

Section 72-5209 (d) of the Kansas School Immunization Law (amended 1994.) Student Name: Address: Parent or Guardian Name: Phone: Birthdate (MM/DD/YYYY): 1st DT DTaP Td Tdap (Diphtheria, Tetanus, Pertussis) Required for 2nd DT DTaP Td Tdap 3rd DT DTaP Td Tdap 4th DT DTaP Td Tdap 5th DT DTaP Td Tdap (Hepatitis B) Required for school entry. Varicella Hx of Disease: Physician Signature: (Chickenpox) Required for school entry. 2 doses grades K-4 & 7-9. One dose Grades 5-6 and 10-12 for .

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the KS Certificate of Immunization (KCI) online

The Kansas Certificate of Immunization (KCI) is an essential document for maintaining a student's immunization record. This guide provides step-by-step instructions for filling out the KCI online, ensuring that you accurately complete each section to comply with state health regulations.

Follow the steps to fill out the KS Certificate of Immunization online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Start by entering the student's name in the designated field. Ensure the name matches the records held by the school or health department.
  3. Provide the student's address, which should include the street, city, and zip code.
  4. Enter the name of the parent or guardian, along with their phone number for contact purposes.
  5. Input the student's birthdate in the format MM/DD/YYYY to verify their age for immunization requirements.
  6. Complete the immunization history for various vaccines by recording the month, day, and year that each dose was received. This includes DTaP, Hepatitis B, Varicella, MMR, Polio, and any others as required.
  7. If there are any additional doses, make sure to initial and sign the form where indicated.
  8. Fill out the fields regarding the student's ethnicity and race, while being mindful to select neutral options.
  9. Ensure you have the physician’s signature in the designated area, affirming the accuracy of the immunization record.
  10. Finally, review all entries for accuracy. Save changes to the form, and utilize available options to download, print, or share the completed document as necessary.

Start completing your Kansas Certificate of Immunization online today!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

KANSAS CERTIFICATE OF IMMUNIZATIONS (KCI)
KCI MAY ONLY BE SIGNED BY A PHYSICIAN (MD/DO), HEALTH DEPT, OR SCHOOL. LEGAL ALTERNATIVES...
Learn more
HBHA Immunization Policy
KANSAS CERTIFICATE OF IMMUNIZATIONS (KCI). This record is part of the ... Kansas...
Learn more

Related links form

Volunteer Waiver 2020 Peraturan Peraturan Angkatan Tentera 2020 WA Our Lady Of Hope School Field Trip Driver Information Form CABS 4 KIDS Registration Form - Forest Ranch Charter School - Forestranchcharter 2020

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

To obtain your immunization records in New York State, you need to contact the healthcare provider who administered your vaccinations. They can provide you with the necessary documentation. If you require a KS Certificate of Immunization (KCI) for out-of-state education or employment, be sure to mention this when requesting your records.

The Kansas Immunization Registry is a secure system that maintains immunization records for individuals in Kansas. This registry helps track vaccination histories and is essential for obtaining the KS Certificate of Immunization (KCI). It enables healthcare providers to access and update immunization information efficiently, promoting public health and safety.

Your immunization form can be completed by your healthcare provider, such as a physician or clinic staff. If you are a student, your educational institution may have specific requirements for who can verify immunization records. To simplify the process and obtain your KS Certificate of Immunization (KCI), you can explore UsLegalForms for comprehensive templates and instructions.

Immunization forms can be filled out by medical professionals, such as doctors or nurses, who administer vaccinations. Additionally, parents or guardians may also complete these forms for their children. It's important to ensure accurate information is provided to obtain a valid KS Certificate of Immunization (KCI). If you need assistance, consider using UsLegalForms for guidance.

To get a copy of your immunization records in Kansas, you can request them from your healthcare provider or local health department. Ensure you specify that you need the KS Certificate of Immunization (KCI) for your records. If you need further assistance, USLegalForms offers resources to help streamline this process.

In Kansas, it is not illegal to choose not to vaccinate your child. However, the state requires a KS Certificate of Immunization (KCI) for school enrollment unless you have a valid exemption. It is important to understand the implications of not vaccinating, including potential restrictions on school admissions.

To submit your immunization records to Hunter College, you will need to send your KS Certificate of Immunization (KCI) directly to their Office of Student Services. You can do this through the online submission portal, or you may choose to send it via email, mail, or fax. Ensuring that your records are accurate and complete will help facilitate your enrollment process.

To obtain your immunization records in Kansas, contact your healthcare provider or your local health department. They can provide you with the KS Certificate of Immunization (KCI) that lists your vaccination history. If you need additional help, you can use platforms like uslegalforms to find the right forms for your needs and obtain your records efficiently.

Yes, many colleges require immunization records, including the KS Certificate of Immunization (KCI), to ensure the safety of their campus community. This requirement helps prevent outbreaks of vaccine-preventable diseases among students. It is important to verify your institution’s specific requirements early on in your application process.

To submit your immunization records to CUNY, you need to provide your KS Certificate of Immunization (KCI) to the appropriate campus office. You can submit your records online through the CUNYfirst system or send them via mail or fax, depending on the college’s requirements. Make sure you check your specific campus guidelines for accurate submission details.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get KS Certificate of Immunization (KCI)
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
KS Certificate of Immunization (KCI)
This form is available in several versions.
Select the version you need from the drop-down list below.
2019 KS Certificate of Immunization (KCI)
Select form
  • 2019 KS Certificate of Immunization (KCI)
  • 2018 KS Certificate Of Immunization (KCI)
  • 2013 KS Certificate of Immunization (KCI)
Select form