The 680 form is a vital document known as the Florida Certification of Immunization. It serves to confirm that a child has received the necessary immunizations required for school attendance in Florida. Understanding how to properly complete this form is essential for parents and guardians to ensure their child’s compliance with state health regulations.
The Florida Certification of Immunization, commonly referred to as Form 680, serves as an official record of a child's immunizations. It is required for school attendance in Florida. This form ensures that children are vaccinated against certain diseases, thereby protecting their health and the health of those around them.
Form 680 must be completed for children who are entering K-12 schools in Florida, including those in daycare, preschool, and kindergarten. It is essential for children transitioning into 7th grade as well, as they have additional immunization requirements.
The form requires several key pieces of information, including:
Form 680 consists of three main parts:
Form 680 can be obtained from various sources, including healthcare providers, schools, and the Florida Department of Health's website. It is important to ensure that the form is the most current version to meet state requirements.
If your child has a medical condition that prevents them from receiving certain vaccinations, you will need to complete Part C of Form 680. This part requires a physician's signature and a detailed explanation of the medical reasons for the exemption.
Yes, there are deadlines for submitting Form 680, particularly before the start of the school year. Parents should check with their child's school for specific deadlines to ensure compliance and avoid any issues with enrollment.
For more information about immunization requirements, parents can visit the Florida Department of Health's website or access the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes. The guidelines provide detailed instructions and resources for completing Form 680.
Understanding the 680 form can be challenging, and several misconceptions may lead to confusion. Here are four common misunderstandings:
This is not true. The 680 form is required for all K-12 students, including those in daycare, preschool, and grades 1 through 12. It ensures that all students meet the necessary immunization requirements for school attendance.
In reality, accurate medical records are essential. Parents must provide documentation of their child's immunizations. This ensures that the information is reliable and meets the state’s requirements.
This is misleading. A temporary medical exemption allows a child to attend school while they are in the process of receiving their immunizations. However, it does not eliminate the requirement for completing the immunization schedule.
This is incorrect. The form must be signed by a physician or authorized clinic representative. This signature verifies that the immunization records are accurate and that the child is compliant with state laws.
Incomplete Information: One common mistake is failing to fill out all required fields, such as the child's last name, first name, or date of birth. Each section is crucial for proper identification and processing.
Incorrect Dates: Entering the wrong dates for immunizations can lead to confusion. Ensure that all vaccine doses are documented with the correct MM/DD/YY format.
Missing Signatures: The form must be signed by the parent or guardian. Omitting this step can invalidate the entire form.
Choosing the Wrong Certificate: Selecting the incorrect certificate (A, B, or C) can result in processing delays. Make sure to choose the certificate that corresponds to the child's immunization status.
Ignoring Guidelines: Not following the guidelines provided in the DH Form 150-615 can lead to errors. Familiarize yourself with these instructions before completing the form.
Failing to Document Exemptions: If a medical exemption applies, it must be clearly documented. Not providing the necessary details can lead to complications.
Neglecting Optional Information: While the child's Social Security number and state immunization ID are optional, providing them can facilitate smoother processing. Omitting this information may slow down the verification process.
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
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