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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 immunization requirements for school attendance in Florida. This form is governed by various legal authorities, including specific sections of the Florida Statutes and the Florida Administrative Code. Parents or guardians must provide essential information, such as the child's name, date of birth, and immunization history. The form requires details about each vaccine administered, including dates and doses, which helps schools verify that students are adequately protected against preventable diseases. Additionally, the 680 form includes sections for temporary and permanent medical exemptions, allowing for flexibility in cases where immunizations may not be advisable. For those completing the form, guidelines are available to assist with the process, ensuring that all necessary information is accurately documented. This certification is not only a requirement for school enrollment but also serves as a vital tool in promoting public health and safety among the student population.
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Document Specifics
| Fact Name | Description |
|---|---|
| Legal Authority | The Florida Certification of Immunization is governed by Sections 1003.22, 402.305, and 402.313 of the Florida Statutes, as well as Rule 64D-3.046 of the Florida Administrative Code. |
| Purpose | This form is used to document the immunization status of children for school attendance in Florida, ensuring that they meet state requirements. |
| Completion Guidelines | Parents or guardians must enter all appropriate doses and dates of immunizations on the form. It is important to sign and date the appropriate certificate (A, B, or C) as instructed. |
| Exemption Options | The form provides options for temporary and permanent medical exemptions, allowing for documentation if immunizations are medically contraindicated. |
How to Write 680
Filling out the Florida Certification of Immunization (Form 680) is an important step in ensuring that your child meets the immunization requirements for school attendance. This form collects essential information about your child's immunization history and allows you to certify their vaccination status. To complete the form accurately, follow these steps:
- Gather necessary information: Before starting, collect your child's full name, date of birth, and any relevant immunization records.
- Complete personal details: Fill in the last name, first name, middle initial, date of birth (MM/DD/YY), parent or guardian's name, child's Social Security number (optional), and state immunization ID number (optional).
- Document immunization doses: For each vaccine listed, enter the date of each dose received in the corresponding Dose 1, Dose 2, Dose 3, Dose 4, and Dose 5 fields.
- Select the appropriate certificate: Choose between Part A, Part B, or Part C based on your child’s immunization status. Make sure to check the relevant box for K-12 immunizations or temporary/permanent medical exemptions.
- Sign and date the form: The parent or guardian must sign and date the certification section to confirm the accuracy of the information provided.
- Review the form: Double-check all entries for accuracy and completeness before submitting.
Once you have filled out the form, it’s essential to submit it to the appropriate school or childcare facility. They will use this information to verify your child’s immunization status and ensure compliance with state regulations.
Dos and Don'ts
When filling out the Florida Certification of Immunization (Form 680), it is essential to follow specific guidelines to ensure accuracy and compliance. Here are nine things to do and not do:
- Do provide complete and accurate information for the child's name, date of birth, and immunization details.
- Do review the immunization records thoroughly before completing the form.
- Do select the appropriate certificate (A, B, or C) based on the child's immunization status.
- Do sign and date the form to validate the information provided.
- Do include the physician or clinic name and authorized signature where required.
- Don't leave any fields blank; incomplete forms may lead to delays or rejection.
- Don't use incorrect codes for vaccines or immunization statuses.
- Don't forget to provide an expiration date for temporary medical exemptions.
- Don't submit the form without ensuring that all information is accurate and up-to-date.
Documents used along the form
The Florida Certification of Immunization, commonly known as the 680 form, is a critical document for children attending school or daycare in Florida. However, it is often accompanied by other forms and documents that further support a child's immunization record or address specific circumstances. Below is a list of these related documents, each serving a unique purpose.
- DH Form 150-615: This form provides detailed immunization guidelines for schools, childcare facilities, and family daycare homes in Florida. It outlines the requirements for immunizations and offers instructions on how to complete the 680 form.
- Temporary Medical Exemption Form: This document is used when a child cannot receive certain vaccinations due to temporary medical conditions. It must specify the duration of the exemption and must be signed by a licensed physician.
- Florida Board Nursing Application - For those in the nursing field, completing the Florida Forms is essential, as it provides the necessary details to apply for licensure and ensures that all qualifications are met for practicing nursing in Florida.
- Permanent Medical Exemption Form: Similar to the temporary exemption, this form is for children who have permanent medical contraindications to vaccinations. It requires documentation from a healthcare provider detailing the medical reasons for the exemption.
- Health History Form: This form collects comprehensive health information about the child, including past illnesses, allergies, and any previous adverse reactions to vaccines. It helps healthcare providers make informed decisions regarding immunizations.
- School Entry Health Exam Form: This document is often required for school entry and includes a physical examination report. It may also indicate whether the child is up to date on immunizations.
- Immunization Record Request Form: Parents may need to use this form to request a copy of their child's immunization records from healthcare providers. It is essential for verifying vaccination status.
- Consent for Immunization Form: This form is typically required for parents to authorize vaccinations for their children. It outlines the specific vaccines to be administered and any potential risks involved.
- Vaccine Information Statements (VIS): These are documents produced by the Centers for Disease Control and Prevention (CDC) that provide information about vaccines. They must be given to parents or guardians before vaccination to ensure informed consent.
- School Health Services Policy: This document outlines the policies and procedures regarding health services provided by schools, including immunization requirements and health screenings.
Understanding these forms and their purposes can help parents navigate the immunization requirements for their children effectively. Each document plays a vital role in ensuring that children are protected against preventable diseases while complying with state regulations.