Get Fl Dh1478 2014-2025

Filling out the FL DH1478 form is an essential step for parents who want to opt out of the Florida SHOTS immunization tracking system. This guide will provide you with clear and concise instructions on how to accurately complete the form online, ensuring that your child's immunization records remain private if you choose not to participate.

Follow the steps to successfully complete the FL DH1478 form online.

1. Click the ‘Get Form’ button to access the FL DH1478 form and open it in your preferred editor.
2. Begin by entering your child's name in the section labeled 'Your Child’s Name.' Make sure to include the first and last name.
3. Fill in your child's date of birth using the format Mo/Day/Year. This information is critical for identifying your child's records.
4. Provide your child's social security number in the designated field. If you are uncomfortable sharing this information, you may skip it, but it is often needed for verification.
5. Indicate your child's sex by circling either 'M' for male or 'F' for female, as required.
6. Complete the state immunization ID section if available. This helps to identify your child's records more efficiently.
7. Fill in your child's county of residence, which helps the Department of Health locate your records.
8. Enter your phone number in the field for the requesting parent's phone number for any future communications.
9. Include the mother's maiden name in the specified field. This information may be used for security purposes.
10. Provide the requesting parent's social security number. This will assist in processing the form.
11. Sign and date the form in the designated area to confirm your request. Your signature indicates that you understand your child's immunization record will not be shared with authorized users.
12. Once you have filled out all necessary fields, review the form for accuracy. Make any corrections if needed.
13. Save your changes, then download and print the completed form to mail it to the Florida Department of Health at the address provided.
14. Mail the form to: Florida Department of Health, Immunization Section, 4052 Bald Cypress Way, Bin A-11, Tallahassee, FL 32399-1719.

Complete your documents online today to ensure your child's immunization choices are respected.