Get Fl Dh Form 684 2016-2026

The FL DH Form 684 is an essential document for reporting immunization compliance for kindergarten and seventh grade students in Florida. This guide provides a step-by-step approach to help users efficiently complete the form online, ensuring all necessary information is accurately submitted.

Follow the steps to complete the FL DH Form 684 online.

1. Click the ‘Get Form’ button to obtain the form, which will open in an editing interface for online completion.
2. In section A, enter the date and the name of the school. Fill out the details of the person completing the form, including their name, address, city, zip code, county, as well as the name and position of the principal, along with their phone number.
3. In section B, provide information only for students who are not fully immunized. List the grade, student name, and indicate the type of exemption or compliance status for each student. Specifically, note any medical exemptions and their expiration dates.
4. In section C, summarize the total number of students for each category, including: students enrolled, fully immunized, medical exemptions (temporary and permanent), and religious exemptions, as well as those out of compliance.
5. Once all sections are filled out completely, review the information for accuracy. Save your changes periodically to ensure no data is lost.
6. After completing the form, download, print, or share the document as required. Make sure to submit it to the local county health department by October 1.

Complete your FL DH Form 684 online today!