DOH 348-013: Washington State Certificate of Immunization Status (CIS)

DOH 348-013 PDF Details

Handwritten forms must have medical immunization records attached for school or child care staff verification.

Printing: if your provider's office enters immunizations into the Immunization Information System, ask them to print the CIS; the information fills in automatically.

Conditional status: children can enter and stay in school or child care in conditional status if they are catching up on required vaccines for school or child care entry.

Chickenpox: if your child had chickenpox (varicella) disease and not the vaccine, a health care provider must verify chickenpox disease to meet school requirements.

Blood test: if your child can show positive immunity by blood test (titer), you must provide lab reports with this CIS.