Free 680 Form in PDF

• Vaccination Record Card: Similar to the 680 form, this card documents a person's vaccination history. It includes details about the vaccines received, including dates and types, making it a crucial tool for tracking immunizations.

• School Health Records: These records compile a child's health information, including immunization status. They are essential for schools to ensure that students meet health requirements for attendance.

• New York Lease Agreement: A Fillable Forms facilitates the renting process by providing clear documentation of terms, responsibilities, and rights for both landlords and tenants, ensuring a successful rental experience.

• Medical Exemption Forms: Like Part C of the 680 form, these documents provide a basis for exempting a child from immunizations due to medical reasons. They require a healthcare provider’s signature and specific clinical justification.

• State Immunization Registry Documents: These documents track vaccination records across a state. They serve a similar purpose as the 680 form by ensuring that immunization data is centralized and accessible for healthcare providers.

• Child Health Assessment Forms: These forms assess a child's overall health and include immunization status. They are often required for school entry, similar to the 680 form's role in documenting immunizations.

• Immunization Schedules: These schedules outline the recommended timing for vaccinations. While they do not document individual immunizations, they provide the framework that informs the information recorded on the 680 form.

• Health Insurance Portability and Accountability Act (HIPAA) Authorization Forms: These forms allow for the sharing of health information, including immunization records. They are similar in that they facilitate the communication of important health data, like the 680 form does for schools and childcare facilities.

Filling out the Florida Certification of Immunization, commonly referred to as the 680 form, is an essential process for ensuring that children meet immunization requirements for school attendance. Here are key takeaways to consider:

• Personal Information: Begin by accurately entering the child's last name, first name, middle initial, and date of birth in the designated fields.
• Parent or Guardian Details: Include the name of the parent or guardian responsible for the child, as well as the child's Social Security number and state immunization ID number, if available.
• Vaccine Documentation: List all required vaccines along with the corresponding doses and dates. Ensure each entry is complete and legible.
• Certificate Selection: Choose the appropriate certificate (A, B, or C) based on the child's immunization status. Each certificate serves a different purpose.
• Temporary Medical Exemption: If applicable, fill out Part B for temporary medical exemptions, ensuring to include an expiration date.
• Permanently Exempt Children: For children with permanent medical exemptions, complete Part C. Clearly state the medical reasoning for the exemption.
• Physician's Verification: A licensed physician or clinic must sign the form to validate the immunization records. This signature is crucial for the form's acceptance.
• Submission Guidelines: After completing the form, submit it to the appropriate school or childcare facility as required. Keep a copy for personal records.
• Stay Updated: Refer to the latest guidelines available at www.immunizeflorida.org/schoolguide.pdf for any changes or updates in the immunization requirements.
• Legal Authority: Familiarize yourself with the legal framework governing the form, including relevant sections of the Florida Statutes and Administrative Code.

By following these key points, parents and guardians can ensure that the 680 form is completed correctly and submitted in a timely manner, thereby facilitating a smooth enrollment process for their children.

Instructions on How to Fill Out 680

Filling out the Florida Certification of Immunization Form (680) is an important step in ensuring that a child's immunization records are properly documented for school or daycare enrollment. Follow these steps carefully to complete the form accurately.

1. Gather Required Information: Collect the child's full name (last name, first name, middle initial), date of birth, and the parent's or guardian's name.
2. Optional Information: If available, include the child's Social Security number and state immunization ID number.
3. Enter Immunization Details: For each vaccine listed, fill in the dates (MM/DD/YY) for the doses received. Ensure that all doses are documented accurately.
4. Select Certificate Type: Choose the appropriate certificate (A, B, or C) based on the child's immunization status:
• Part A for complete immunizations for K-12.
• Part B for temporary exemptions for children in daycare or preschool.
• Part C for permanent medical exemptions.
5. Provide Certification: Sign and date the certificate section relevant to your selection. Include the physician or clinic name if applicable.
6. Submit the Form: Once completed, submit the form to the appropriate school or childcare facility as required.

After filling out the form, ensure that all information is accurate and complete. This will help avoid any delays in enrollment or attendance at school or daycare. Keep a copy of the completed form for your records.