The 680 form, officially known as the Florida Certification of Immunization, serves as a crucial document for verifying a child's immunization status in compliance with state regulations. This form is essential for school enrollment and childcare facilities, ensuring that children are protected against preventable diseases. Understanding its requirements and proper completion is vital for parents and guardians to facilitate their child's educational journey.
The Florida Certification of Immunization, commonly known as the 680 form, is an essential document for parents and guardians navigating the school enrollment process for their children. This form is rooted in various Florida statutes and administrative rules, ensuring that children meet the necessary immunization requirements before attending school or daycare. It requires parents to provide specific details, such as the child’s name, date of birth, and immunization history, including dates for each vaccine received. The form also offers sections for different scenarios: a complete immunization record, a temporary medical exemption, or a permanent medical exemption. Each section has its own certification codes, making it easier for healthcare providers and schools to understand a child's immunization status. Completing this form accurately is crucial, as it directly impacts a child's eligibility for school attendance. For additional guidance, parents can refer to the Immunization Guidelines available online, which provide further instructions on how to fill out the 680 form correctly.
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This is not accurate. The 680 form is required for all students attending K-12 schools in Florida, including those in daycare, preschool, and even those entering the 7th grade. It documents a child's immunization history, ensuring they meet the necessary health requirements for school attendance.
This is incorrect. The 680 form must be filled out with accurate immunization dates and doses. Parents need to provide documentation of their child's vaccinations. Without this information, the form is incomplete and cannot be accepted.
These are two different forms. While the 680 form focuses on immunizations, the health examination form addresses a child's overall health status. Both are important for school enrollment, but they serve distinct purposes.
This is misleading. Parents should update the form whenever their child receives new vaccinations. Keeping the form current is essential for compliance with school health regulations.
This is not true. A temporary medical exemption allows a child to attend school while they are in the process of completing their immunizations. It does not provide a permanent exemption, and parents must ensure that the child receives the required vaccinations within the specified time frame.
This is partially incorrect. The form allows for a temporary exemption if a child has started the vaccination schedule but has not yet completed all doses. Parents can submit the form to document the vaccinations that have been received and outline a plan for completing the immunization schedule.
When filling out the Florida Certification of Immunization form (680 form), there are several important points to keep in mind:
By following these key takeaways, you can ensure that the 680 form is completed correctly and that your child's immunization records are properly documented.
When completing the Florida Certification of Immunization (Form 680), it is important to follow certain guidelines to ensure accuracy and compliance. Below is a list of recommended actions and those to avoid.
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