Get Ks Certificate Of Immunization (kci) - Form B 2019
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How to fill out the KS Certificate Of Immunization (KCI) - Form B online
The Kansas Certificate Of Immunization (KCI) - Form B is essential for documenting medical exemptions for vaccinations. This guide provides a detailed overview of the steps needed to complete this form online, ensuring you fill it out accurately and efficiently.
Follow the steps to effectively complete the form
- Press the ‘Get Form’ button to access the form and view it in the editing interface.
- Begin by entering the student's full name in the 'Student Name' field, followed by their birthdate in the designated space.
- Provide the student's residential address, including the 'Street Address', 'City', 'State', and 'Zip Code' fields.
- In the 'Parent/Guardian' section, enter the name of the parent or guardian responsible for the student and include their telephone number.
- Indicate the reason for the medical exemption by clearly stating the medical condition in the provided section.
- For each vaccine for which a medical exemption is claimed, mark the relevant checkbox. This includes vaccines like DTaP, Tdap, Polio, MMR, and others.
- Complete the physician’s information by inputting their name, address, and telephone number in the respective fields.
- Ensure the physician certifies the exemption by including their signature and medical license number. This is critical for the validation of the medical exemption.
- Finally, input the date of completion and the state where the physician is licensed.
- Review all entered information for accuracy, then proceed to save your changes, download, print, or share the completed form as needed.
Complete the KS Certificate Of Immunization (KCI) - Form B online today to ensure proper documentation of medical exemptions.
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To submit your immunization records to the University of Kansas (KU), you will need to provide your KS Certificate Of Immunization (KCI) - Form B along with any other required documents. You can usually submit these records online through the student health portal, or you may need to send them directly to the student health service. Always check with KU for the latest submission guidelines.
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