Florida Medical Exemption Vaccine Form – Fill Out and Use This PDF

Florida Medical Exemption Vaccine Form PDF Details

In Florida, ensuring that children are immunized according to state guidelines is a critical step towards their admission into schools, childcare facilities, and family daycare homes. The Florida Certification of Immunization, underpinned by Sections 1003.22, 402.305, 402.313 of the Florida Statutes and Rule 64D-3.046 of the Florida Administrative Code, serves as an essential document in this process. This form meticulously records the child's name, date of birth, and the parent or guardian's details, with options to include the child's Social Security and State Immunization ID numbers. It demands the detailed entry of all administered vaccine doses and their respective dates, spanning a range of immunizations from DTaP/DTP through to Varicella and pneumococcal vaccines. The form is segmented into three significant parts: Certificate of Immunization for K-12 (Part A), Temporary Medical Exemption (Part B), and Permanent Medical Exemption (Part C), each section catering to different immunization statuses and requirements. Notably, the form allows for the documentation of temporary medical exemptions, with a mandatory expiration date, and permanent medical exemptions, where a physician must list each contraindicated vaccine along with valid clinical reasons or evidence for the exemption. This document, once completed, signed, and dated by an authorized physician or clinic, stands as a testament to a child's immunization status in alignment with Florida's public health requirements, offering a structured pathway for ensuring that immunizations are up to date or appropriately exempted for medical reasons.