680 PDF Form

1. What is the Florida Certification of Immunization (Form 680)?

   The Florida Certification of Immunization, commonly known as Form 680, is an official document that records a child’s immunization history. It is required for school attendance in Florida, ensuring that children are vaccinated according to state health guidelines.

2. Who needs to complete Form 680?

   Form 680 must be completed for children who are enrolling in K-12 schools in Florida. This includes those entering kindergarten and those advancing to 7th grade, where additional immunization requirements apply.

3. What information is required on Form 680?

   The form requires the child’s full name, date of birth, parent or guardian’s name, and optional details like the child’s Social Security number and state immunization ID number. Additionally, it must include specific vaccine doses and dates for each immunization received.

4. What vaccines are documented on Form 680?

   The form includes various vaccines such as DTaP/DTP, Polio, MMR, Hepatitis B, and Varicella, among others. Each vaccine has designated spaces for recording multiple doses along with the corresponding dates.

5. What are the different parts of Form 680?

   Form 680 is divided into three parts:

   • Part A: Certifies that the child’s immunizations are complete.
   • Part B: A temporary certificate for children who have started their immunization schedule but are not yet fully vaccinated.
   • Part C: A permanent medical exemption for children who cannot receive certain vaccines due to medical reasons.

6. How do I obtain Form 680?

   Form 680 can be obtained from healthcare providers, schools, or downloaded from the Florida Department of Health website. It is important to ensure that the form is filled out completely and accurately to avoid any issues with school enrollment.

7. What should I do if my child has a medical exemption?

   If your child has a medical exemption, you will need to complete Part C of Form 680. This section requires a physician's signature and a valid clinical reason for the exemption. Ensure that this information is clearly documented to prevent any complications.

8. Are there any deadlines for submitting Form 680?

   Form 680 should be submitted prior to the start of the school year or upon enrollment in school. It is advisable to check with the specific school for any additional deadlines or requirements related to immunization documentation.

9. Where can I find more information about immunization requirements?

   For further details on immunization requirements and guidelines, visit the Florida Department of Health's website or refer to the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes. The guidelines can be accessed at www.immunizeflorida.org/schoolguide.pdf.

Detailed Guide for Using 680

After gathering the necessary information, you can begin filling out the Florida Certification of Immunization (Form 680). This form is essential for school attendance in Florida. Make sure to have your child's vaccination records handy to ensure accuracy.

1. Write your child's last name in the designated space.
2. Fill in your child's first name and middle initial (MI).
3. Enter your child's date of birth in the format MM/DD/YY.
4. Provide the parent or guardian's name.
5. If applicable, include your child's Social Security number (optional).
6. Fill in the state immunization ID number (optional).
7. For each vaccine listed, enter the dose numbers and dates received in the appropriate columns.
8. Select the appropriate box for the certificate of immunization (Part A, B, or C) based on your child's immunization status.
9. If you are certifying a temporary or permanent medical exemption, provide the necessary details as instructed in Parts B or C.
10. Sign and date the form where indicated.

Once you have completed the form, review it for accuracy. Make sure all required sections are filled out and that your signature is present. After that, submit the form to the appropriate school or childcare facility as required.

The Florida Certification of Immunization Form 680 is a crucial document for ensuring that children meet the immunization requirements for school attendance. Alongside this form, several other documents may be necessary to provide a comprehensive view of a child's immunization status. Below is a list of related forms and documents commonly used in conjunction with the 680 form.

• DH Form 150-615: This document provides guidelines for completing the Certification of Immunization Form. It includes instructions on the required immunizations for children attending schools, childcare facilities, and family daycare homes in Florida.
• Temporary Medical Exemption Form: This form is used when a child cannot receive certain vaccinations due to temporary medical reasons. It must include an expiration date and is valid only for a limited time.
• Permanent Medical Exemption Form: For children who have permanent medical contraindications to vaccinations, this form lists the specific vaccines and provides clinical reasoning for the exemption.
• Health Records: Comprehensive health records may be required to document a child's immunization history. These records often include previous vaccinations, dates administered, and any adverse reactions.
• School Enrollment Forms: Schools may require additional enrollment documents that include immunization records as part of the registration process for new students.
• Parent or Guardian Consent Forms: Before administering vaccines, healthcare providers often need consent from a parent or guardian. This form outlines the vaccines to be given and any potential risks.
• Immunization Registry Documentation: In some states, immunization records are maintained in a centralized registry. Documentation from this registry may be requested to verify a child's immunization status.
• Physician's Letter: A letter from a physician may be required to confirm a child's immunization status or to provide justification for medical exemptions.
• School Health Policies: Schools often have their own health policies regarding immunizations. Familiarity with these policies can help parents understand the requirements and any additional documentation needed.

These forms and documents work together to ensure that children are properly immunized and that schools comply with state regulations. Parents and guardians should be prepared to gather and submit these materials as needed to facilitate their child's school enrollment and attendance.

The Florida Certificate of Immunization (Form 680) shares similarities with the School Health Record, which is commonly used in educational settings. Both documents track a child's health information, particularly their immunization history. The School Health Record typically includes sections for recording vaccinations, health screenings, and any medical conditions that may affect a child's participation in school activities. Like the 680 form, it serves to ensure that children meet health requirements for school attendance, providing a comprehensive overview of their health status.

Another document akin to the 680 form is the Immunization Record from a healthcare provider. This record is maintained by doctors or clinics and documents all vaccinations a child has received. Both forms require detailed entries of vaccine types and dates administered. The Immunization Record is often used for school enrollment and can serve as a reliable source for verifying a child’s immunization status, similar to the purpose of the Florida Certificate of Immunization.

The Certificate of Medical Exemption is also comparable to the 680 form. This document is issued when a child cannot receive certain vaccinations for medical reasons. Like the 680 form, it requires a physician's signature and details about the specific immunizations that are contraindicated. Both documents play a crucial role in ensuring that children who cannot be vaccinated for valid medical reasons are still accounted for in school health records, thus maintaining public health standards.

Additionally, the Child Health Passport is similar to the 680 form in that it serves as a comprehensive health record for children. It often includes immunization history, growth charts, and developmental milestones. Both documents are essential for tracking a child's health and ensuring they meet the necessary requirements for school entry. The Child Health Passport may also be used to facilitate communication between parents and healthcare providers regarding a child's health status.

Lastly, the Vaccine Administration Record (VAR) aligns closely with the Florida Certificate of Immunization. The VAR is a record kept by healthcare providers that documents the administration of vaccines. It includes details such as vaccine type, lot number, and administration date. Both the VAR and the 680 form ensure that accurate immunization information is available for school requirements, helping to maintain public health and safety by confirming that children are up-to-date on their vaccinations.