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Get Immunization Document - The Chicago School's Field Placement ... - Fieldplacement2
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How to fill out the Immunization Document - The Chicago School's Field Placement online
Completing the Immunization Document for The Chicago School's Field Placement is essential for new students to demonstrate compliance with state immunization laws. This guide will walk you through the necessary steps to accurately fill out the document online.
Follow the steps to complete your immunization document effectively.
- Press the ‘Get Form’ button to obtain the Immunization Document and open it in your preferred editing tool.
- Fill in Part I with your personal information, including your last name, first name, middle initial, date of birth, sex, student ID number, phone number, and the term of admission.
- In Part II, check the box indicating compliance by providing a copy of your Certificate of Child Health Examination. This document must be attached.
- Authorize the release of your immunization record to the Illinois Department of Public Health by signing and dating the authorization section.
- Move to Part III and ensure that a qualified health care provider completes and signs this section. All dates must include the month, day, and year, noting details of your tetanus/diphtheria vaccinations.
- Document your measles, rubella, and mumps immunizations in the provided fields, ensuring to include vaccination dates or physician confirmation if applicable.
- If you have any exemptions, attach the required physician’s statements and ensure they are properly signed and dated.
- Ensure that your health care provider fills out their verification details, including their name, signature, address, and telephone number.
- Review the entire document for completeness. Once ensured, you may save changes, download, print, or share the completed form as needed.
Complete your immunization document online today to ensure your compliance!
Yes, you can often access your immunization records through MyChart, which is a patient portal provided by many healthcare systems. Log into your MyChart account and navigate to your immunization section to view or print your records. If you need specific forms, check with U.S. Legal Forms for additional resources.
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