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The Florida Certification of Immunization, commonly referred to as the 680 form, plays a crucial role in the health and safety of children attending schools and childcare facilities across the state. This form is not merely a piece of paperwork; it is a vital document that ensures children are up-to-date with their vaccinations, which is essential for preventing the spread of infectious diseases. The 680 form is governed by specific legal authorities, including various sections of the Florida Statutes and the Florida Administrative Code, which outline the requirements for immunization documentation. Parents or guardians must provide essential information, such as the child’s full name, date of birth, and optional identification numbers. The form requires detailed entries for each vaccine received, including dates for multiple doses of vaccines like DTaP, MMR, and Hepatitis B. Additionally, it includes sections for certifying complete immunizations, temporary medical exemptions, and permanent medical exemptions, allowing for flexibility in cases where vaccinations may not be medically advisable. Clear instructions guide users through the process of completing the form, ensuring that it meets the necessary criteria for school attendance. For those needing further assistance, resources are readily available, including the Immunization Guidelines for Florida Schools, which provide comprehensive information on how to navigate the requirements effectively.

How to Write 680

Filling out the Florida Certification of Immunization (Form 680) is a straightforward process. This form is essential for documenting a child's immunization status for school attendance. After completing the form, it should be signed and dated, and any necessary certificates should be selected based on the child's immunization history.

  1. Gather necessary information: Collect the child's full name, date of birth, and, if available, the child's Social Security number and state immunization ID number.
  2. Complete the vaccine section: For each vaccine listed, enter the dose number and the corresponding date received in the format MM/DD/YY.
  3. Select the appropriate certificate: Choose Part A, B, or C based on the child's immunization status. Ensure you understand the requirements for each part.
  4. Fill out the selected certificate: If using Part A, confirm that immunizations are complete. For Part B, indicate any incomplete immunizations and provide an expiration date. For Part C, list any medically contraindicated vaccines with valid reasoning.
  5. Sign and date the form: The authorized person, typically a parent or guardian, should sign and date the form in the designated areas.
  6. Submit the form: Provide the completed form to the appropriate school or childcare facility as required.

Misconceptions

Here are five common misconceptions about the Florida 680 form, which is used for certification of immunization for school attendance:

  • Misconception 1: The 680 form is only for children entering kindergarten.
  • This form is actually required for all K-12 students, including those in daycare, preschool, and grades 1 through 12. It ensures that all children have the necessary immunizations regardless of their grade level.

  • Misconception 2: Completing the 680 form guarantees that a child will be admitted to school.
  • While the form is necessary for school attendance, it does not automatically guarantee admission. Schools may have additional requirements or policies that must also be met.

  • Misconception 3: Parents can fill out the form without any medical documentation.
  • Parents must provide accurate immunization records from a healthcare provider. The form requires specific doses and dates for each vaccine, which must be verified by a medical professional.

  • Misconception 4: The 680 form is the only document needed for immunization verification.
  • In some cases, additional documentation may be required, such as proof of a temporary or permanent medical exemption. Each school may have its own policies regarding documentation.

  • Misconception 5: The 680 form can be submitted at any time during the school year.
  • It is important to submit the form before the start of the school year or as required by the school’s registration process. Delays in submission may affect a child’s ability to attend school.

680 Example

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

 

MM/DD/YY

 

MM/DD/YY

 

MM/DD/YY

 

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

Key takeaways

When it comes to ensuring your child is ready for school in Florida, the 680 form plays a vital role in documenting immunizations. Here are some key takeaways to consider when filling out and using this important form:

  • Accurate Information is Crucial: Always double-check that the child's name, date of birth, and immunization dates are entered correctly. Mistakes can lead to delays in school enrollment or complications with daycare facilities.
  • Understand the Certificate Options: The form includes different sections for various situations—complete immunization records, temporary exemptions, and permanent medical exemptions. Be sure to select the appropriate certificate based on your child's immunization status.
  • Consult the Guidelines: Reference the Immunization Guidelines provided by the Florida Department of Health. This resource offers essential information on how to complete the form accurately and what immunizations are required for school attendance.
  • Sign and Date: Don’t forget to sign and date the form after filling it out. An unsigned form is invalid and may not be accepted by schools or childcare facilities.

By keeping these takeaways in mind, you can navigate the process of filling out the 680 form with confidence, ensuring that your child meets all necessary immunization requirements for school.

Dos and Don'ts

When filling out the Florida Certification of Immunization (Form 680), it is crucial to approach the task with care and attention to detail. Here are nine important do's and don'ts to keep in mind.

  • Do ensure that all required fields are completed accurately, including the child's name and date of birth.
  • Don't leave any sections blank; incomplete forms may lead to delays or complications.
  • Do double-check the dates of immunizations to ensure they are correct and in the proper format (MM/DD/YY).
  • Don't use abbreviations or shorthand that may confuse the reader; clarity is key.
  • Do review the immunization guidelines provided on the Florida Department of Health website for any updates or additional instructions.
  • Don't forget to sign and date the certificate; an unsigned form is invalid.
  • Do include any optional information, such as the child's Social Security number or state immunization ID, if available.
  • Don't submit the form without verifying that all necessary immunizations are documented.
  • Do keep a copy of the completed form for your records, as it may be needed in the future.

Similar forms

The Certificate of Immunization for K-12 is similar to the FLORIDA CERTIFICATION OF IMMUNIZATION form in that both documents serve as proof of a child's immunization status for school attendance. They require details such as the child's name, date of birth, and the specific vaccines received. Additionally, both forms provide options for temporary or permanent medical exemptions, allowing parents to document any medical reasons that may prevent their child from receiving certain vaccinations.

The Child Health Certificate is another document that aligns with the FLORIDA CERTIFICATION OF IMMUNIZATION. This certificate is often required for school enrollment and verifies that a child has received necessary vaccinations and health screenings. Like the 680 form, it includes a section for a healthcare provider's signature, confirming the child's health status and immunization compliance.

The Immunization Record is similar in purpose to the FLORIDA CERTIFICATION OF IMMUNIZATION, as it tracks a child's vaccination history. This document can be used to show that a child has received all required immunizations. Parents often present this record when enrolling their children in schools or daycare facilities, just as they would with the 680 form.

The Health Assessment form serves a similar function by providing a comprehensive overview of a child's health, including immunization status. Schools may require this form to ensure that children are healthy and up-to-date on vaccinations. Both documents emphasize the importance of immunizations in maintaining public health and safety in educational settings.

The School Entry Health Form is another document that parallels the FLORIDA CERTIFICATION OF IMMUNIZATION. This form is typically required for new students and includes sections for documenting vaccinations, health conditions, and any required medical exemptions. Both forms aim to ensure that children meet health requirements before attending school.

The Child Support Texas form is crucial for establishing clear financial responsibilities related to child support obligations. This form not only indicates the party responsible for making payments but also details the specific amount to be contributed and conditions under which the obligation may cease. Understanding and correctly filling out this document is essential for parents navigating child support issues, as it upholds the legal framework established in Texas. For those looking for comprehensive resources, Texas PDF Templates can provide valuable assistance in obtaining the necessary forms.

The Vaccine Administration Record is similar in that it documents the specific vaccines a child has received. This record is often used by healthcare providers to track immunizations and can be presented to schools as proof of compliance. Both the Vaccine Administration Record and the 680 form play crucial roles in managing a child's immunization history.

The Student Health Record is also comparable to the FLORIDA CERTIFICATION OF IMMUNIZATION. This record maintains a comprehensive account of a child's health history, including immunizations, allergies, and other medical concerns. Schools may request this document to ensure that students are safe and healthy while attending classes.

Finally, the Medical Exemption Form is similar as it provides a way for parents to formally request an exemption from immunization requirements due to medical reasons. Like the 680 form, it requires a healthcare provider's signature and outlines the specific vaccines for which the child is exempt. Both documents aim to balance public health needs with individual medical considerations.