The 680 form, also known as the Florida Certification of Immunization, is a document required for school enrollment in Florida. It verifies that a child has received the necessary vaccinations as mandated by state law. Completing this form accurately is crucial for ensuring that children meet immunization requirements for school attendance.
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The Florida Certification of Immunization, commonly referred to as the 680 form, plays a crucial role in ensuring that children meet the necessary immunization requirements for school attendance. This form is backed by various legal authorities, including sections of the Florida Statutes and the Florida Administrative Code, which underline its importance in public health. Parents or guardians are required to fill out essential details, such as the child’s name, date of birth, and immunization history. The form includes sections for documenting multiple vaccine doses, allowing for a clear record of compliance with state immunization laws. It also offers options for temporary or permanent medical exemptions, ensuring that those with valid medical reasons can still navigate school enrollment without unnecessary hurdles. For those seeking guidance, the form references additional resources, including the Immunization Guidelines for Florida Schools, which provide comprehensive instructions on completion. Understanding the nuances of the 680 form can help parents ensure their children are ready for school while adhering to state health regulations.
The FLORIDA CERTIFICATION OF IMMUNIZATION form, commonly known as the 680 form, is essential for documenting a child's immunization history. However, there are other important forms and documents that are often used alongside it. Here’s a brief overview of these additional documents.
Having these documents ready can make the process smoother when enrolling a child in school or daycare. It's always a good idea to keep everything organized and accessible for easy reference.
FLORIDA CERTIFICATION OF IMMUNIZATION
Legal Authority: Sections 1003.22, 402.305, 402.313, Florida Statutes; Rule 64D-3.046, Florida Administrative Code
LAST NAME
FIRST NAME
MI
DOB (MM/DD/YY)
PARENT OR GUARDIAN
CHILD’S SS# (optional)
STATE IMMUNIZATION ID# (optional)
Directions:
Enter all appropriate doses and dates below.
Sign and date appropriate certificate (A, B,or C) on form.
See DH Form 150-615, Immunization Guidelines - Florida Schools, Childcare Facilities and Family Daycare Homes (July 2010) for information and instructions on form completion. Guidelines are available at: www.immunizeflorida.org/schoolguide.pdf.
VACCINE
DOE
Dose 1
Dose 2
Dose 3
Dose 4
Dose 5
CODE
MM/DD/YY
DTaP/DTP
A
DT
B
Tdap
P
Td
Q
Polio
D
Hib
E
MMR (Combined)
F
(Separate)
G, H
Measles (dose 1)
Measles (dose 2)
Mumps (dose 1)
Mumps (dose 2)
I
Rubella (dose 1)
Rubella (dose 2)
Hepatitis B
J
Varicella
K
Varicella Disease
L
Year
PneumoConju N
Select appropriatebox(es)
Certificate of Immunization forK-12
Part A-Complete
DOE Code 1: Immunizations are complete K-12 (Excluding 7th grade/middle school requirements)
DOE Code 8: Immunizationsare complete for 7th grade
I have reviewed the records available,and to the best of my knowledge, the above named child has adequately been immunized for school attendance, as documented above.
Temporary Medical Exemption
Expiration date: _____________
Part B-Temporary
Part B (For children in daycare, family daycare homes, preschool, kindergarten and grades 1 through 12 who are incomplete for immunizations in Part A) Invalid without expiration date. DOE Code 2
I certify that the above named child has received the immunizations documented above and has commenced a schedule to complete the required immunization. Additional immunizations are not medically indicated at this time.
Permanent Medical Exemption
Part C-Permanent
Part C (For medically contraindicated immunizations, list each vaccine and state valid clinical reasoning or evidence for exemption.) DOE Code 3 ________________________________________________________________________________________
I certify the physical condition of this child is such that immunizations as indicated in Part C above are medically contraindicated.
Physician or Clinic Name:
Physician or
_________________________________________________
Authorized Signature: ____________________________________
Issued By:_____________________________________________
Date: _________________________________________________
DH 680 (Jul 2010) Stock Number: 5740-000-0680-6
Completing the Florida Certification of Immunization form, also known as the 680 form, is an important step in ensuring that your child meets the immunization requirements for school attendance. After filling out the form, you will need to submit it to the appropriate school or childcare facility. Here are the steps to guide you through the process of filling out the form.
Once you have filled out the form, review it for any errors before submitting it to the school or childcare facility. Keeping a copy for your records may also be beneficial.
The Florida Certification of Immunization, commonly known as the DH 680 form, is essential for ensuring that children meet immunization requirements for school and daycare. A similar document is the Certificate of Immunization from the Centers for Disease Control and Prevention (CDC). This CDC certificate serves a similar purpose, documenting a child's vaccination history to ensure they are up-to-date with required immunizations. Both forms emphasize the importance of vaccination for public health and require signatures from healthcare providers to validate the information provided.
Another comparable document is the School Immunization Record. This record is often maintained by schools to track the immunization status of students. Like the DH 680 form, it includes details about the vaccines administered, dates, and any exemptions. Schools rely on this document to enforce immunization policies and ensure the safety of all students within their facilities.
The Immunization Registry Record is also similar to the DH 680 form. This state-maintained database collects and stores immunization records for individuals. Parents can access their child's immunization history through this registry, which helps ensure that all vaccinations are accounted for. Both documents provide a reliable way to confirm that children have received necessary immunizations.
The Medical Exemption Form is another document that aligns with the DH 680 form. This form is used when a child cannot receive certain vaccinations due to medical reasons. It requires a healthcare provider's signature, just like the DH 680, to confirm that the exemption is valid. Both forms aim to protect children's health while allowing for exceptions when necessary.
The Religious Exemption Form is similar in purpose to the Medical Exemption Form. This document allows parents to opt out of immunizations for religious reasons. Just as with the DH 680 form, it requires a signature from a parent or guardian and may need to be submitted to schools or daycare facilities to ensure compliance with state laws.
Understanding the nuances of your obligations is essential; therefore, we encourage you to explore the Washington Non-disclosure Agreement form for detailed insights on safeguarding your confidential business information. Explore our Washington Non-disclosure Agreement form to ensure your proprietary data is well protected.
The Child Health Assessment Form is another related document. This form is often required by schools and childcare centers to evaluate a child's overall health, including immunization status. It includes sections for recording vaccinations, making it similar to the DH 680 form in its focus on health and safety for children in educational settings.
The Vaccine Administration Record is also akin to the DH 680 form. This document is filled out by healthcare providers each time a vaccine is administered. It serves as a detailed log of vaccinations received, including dates and types of vaccines. Both forms are critical for maintaining accurate immunization records and ensuring compliance with school requirements.
The Child's Health Record is another document that resembles the DH 680 form. This comprehensive record includes various health information, including immunizations, growth milestones, and medical history. It is often used by healthcare providers and schools to monitor a child's health and development, ensuring that immunizations are up-to-date.
Lastly, the Health Insurance Portability and Accountability Act (HIPAA) Authorization Form can be seen as related. While it primarily deals with the privacy of health information, it may be necessary when sharing immunization records with schools or other entities. Both the DH 680 form and the HIPAA Authorization Form emphasize the importance of protecting children's health information while ensuring that necessary immunization data is accessible when required.
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Understanding the Florida Certification of Immunization, commonly known as the 680 form, is essential for parents and guardians. However, several misconceptions exist regarding its purpose and use. Below is a list of ten common misconceptions along with clarifications.
It is crucial for parents and guardians to understand the facts surrounding the 680 form to ensure compliance with immunization requirements and to support their child's educational journey.