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Examples Of Completed Immunization Forms: What You Should Know

Immunization Record. • Vaccination record generated at the Medical Provider's Office or Preschool. • Vaccination record generated at the County Department of Health / School Health Agency. • Records of non-vaccinated household members. ► See page 1 to record for children in a child-care center (CC) (MMR vaccine is only required for children in a child-care center (CC). Children in a CC are required to get a second dose of MMR vaccine before school entry. Children in a CC may not attend school until they have gotten two separate doses of MMR vaccine.) For additional information go to the following websites: California's Child Day Care Information Sheet Vaccines for Children in Child-Care Centers. Note: For information about vaccines and immunizations and to locate a doctor you may contact the California Childcare Provider Directory. This directory lists child care providers with California vaccination records. The directory also lists additional information about California child care providers. You must complete and sign Immunization Documentation Required by law, immunizations must be documented on a medical record. The physician or healthcare provider must provide the form (see above) and a copy of the medical record to the person requesting the immunization. (The form may be printed out.) The physician OR healthcare provider writing the immunization must record the medical information (i.e. the name of the individual, birthdate and vaccination history) and the date (for each vaccination) the immunization was administered. If the person requesting the immunization has a specific medical reason that restricts them from getting vaccines, and that medical reason was clearly documented on the medical record, the healthcare professional doing the Immunization should not be required to produce a medical document, but you are allowed to sign the form for them How Many Vaccinations Should I Get For All Measles Cases Asking about all measles cases? • 1 vaccination or a booster • 2-3 vaccines Including all groups (except those mentioned later in this report). • All individuals • Children 4 to 11 • Children 12 to 23 • Adults • Adult males • Adult females 1. Get 1 dose of MMR vaccine. Vaccine can last up to 21 months. • 1 dose of MMR vaccine. Vaccine can last up to 21 months. • Two doses of MMR vaccine. Vaccine can last up to 21 months. • 2 doses of MMR vaccine. Vaccine can last up to 21 months. • An injectable.

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