The Immunization Record form is an essential document that tracks a person's vaccination history. It serves as proof of immunization, which is crucial for school and childcare enrollment in California. Parents must keep this record safe, as it verifies compliance with state immunization requirements.
To ensure your child meets these requirements, please fill out the form by clicking the button below.
Here are 10 common misconceptions about the Immunization Record form, along with clarifications for each:
The Immunization Record form is an essential document that helps track a child's vaccination history, ensuring compliance with school and childcare requirements. Alongside this form, several other documents are commonly used to provide a complete picture of a child's health and immunization status. Below are some of these important forms and documents.
These documents, when used in conjunction with the Immunization Record, help ensure that children meet health requirements and are protected against preventable diseases. Proper documentation not only facilitates school enrollment but also supports public health initiatives aimed at safeguarding the community.
Completing the Immunization Record form accurately is crucial for ensuring that children meet school and childcare requirements. One common mistake is failing to provide complete personal information. Parents often neglect to fill in the child's full name or birthdate, which can lead to confusion or delays in processing the record.
Another frequent error involves inaccurate vaccine information. Parents may misremember the dates or types of vaccines administered. This can result in a record that does not reflect the child's actual immunization history, potentially jeopardizing their enrollment in school.
Many individuals also overlook the section for allergies. Leaving this blank can pose health risks, especially if the child has known allergies to certain vaccines. It is essential to provide this information to ensure the child's safety during future vaccinations.
Some parents fail to sign the form, which is another mistake that can invalidate the record. A signature indicates that the information provided is accurate and that the parents acknowledge their child's vaccination history. Without this, the document may not be accepted by schools or childcare facilities.
In addition, not retaining the document is a common oversight. Parents often misplace the Immunization Record after submitting it, leading to difficulties in obtaining proof of immunization when needed in the future. Keeping a copy is advisable for personal records.
Another mistake is not updating the form as new vaccinations occur. Parents should ensure that the Immunization Record reflects the most current information. Failing to do so can create gaps in the child's immunization history, which may raise concerns during school enrollment.
Lastly, many people do not check for errors in the printed information. Sometimes, the healthcare provider may make mistakes when entering data. Parents should review the form carefully before submission to catch any discrepancies that could lead to complications later.
IMMUNIZATION RECORD
Comprobante de Inmunización
Name nombre
Birthdate
Sex
fecha de nacimiento
sexo
Allergies
alergias
Vaccine Reactions
reacciones a la vacuna
RETAIN THIS DOCUMENT — CONSERVE ESTE DOCUMENTO
DATE
NEXT
GIVEN
DOSE DUE
VACCINE
fecha de
DOCTOR OFFICE OR CLINIC
próxima
vacuna
vacunación
médico o clínica
Parents: Your child must meet California’s immunization requirements to be enrolled in school and child care. Keep this Record as proof of immunization.
Padres: Su niño debe cumplir con los requisitos de vacunas para asistir a la escuela y a la guardería. Mantenga este Comprobante: lo necesitará.
DT/Td = Diphtheria, tetanus
[difteria, tétano]
DTaP/Tdap = Diphtheria, tetanus, and pertussis (whooping cough)
[difteria, tétano, y tos ferina]
DTP = Diphtheria, tetanus, pertussis (whooping cough)
HEP A = Hepatitis A
HEP B = Hepatitis B
HIB = Hib meningitis (
Haemophilus influenzae
type b)
[meningitis Hib]
HPV = Human papillomavirus
[virus del papiloma humano]
INFV = Influenza [la gripe]
MCV = Meningococcal conjugate vaccine [vacuna meningocócia conjugada]
MMR = Measles, mumps, rubella [sarampión, paperas y rubéola (sarampión alemán)]
MPV = Meningococcal polysaccharide vaccine
[vacuna meningocócia polisacárida]
PNEUMO = Pneumococcal vaccine [neumocócica]
POLIO = Poliomyelitis
[poliomielitis]
RV = Rotavirus [rotavirus]
VZV = Varicella (chickenpox)
[varicela]
Registry ID Number
TB SKIN TESTS*
Pruebas de la Tuberculosis
Type**
Date given
Given by
Date read
Read by
mm/indur
Impression
* A chest x-ray may be indicated if skin test is positive.
** If required for school entry, must be Mantoux unless exception granted by local health department.
CHEST X-RAY
Film date: ____/____/____
Interpretation:
normal
abnormal
[Radiografiá]
Person is free of communicable tuberculosis
yes
no
(Necessary if skin test positive.)
Signature/Agency: __________________________________________________
PM 298 F2 (8/08) IMM-75LK
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