Blank 680 Template

1. What is the purpose of the Florida Certification of Immunization (Form 680)?

   The Florida Certification of Immunization, commonly known as Form 680, serves as an official record of a child's immunizations. It is required for school attendance in Florida, ensuring that children are vaccinated against various diseases. The form verifies compliance with state immunization laws and helps schools maintain a safe environment for all students.

2. Who needs to fill out Form 680?

   Form 680 must be completed for all children entering kindergarten through 12th grade in Florida. Additionally, it is required for children attending daycare, family daycare homes, and preschool programs. Parents or guardians should provide the necessary immunization information to ensure their child's enrollment.

3. What information is required on Form 680?

   The form requires the child's full name, date of birth, and optionally, the child's Social Security number and state immunization ID. Parents or guardians must enter the dates of each vaccine received, along with the corresponding vaccine codes. The form also includes sections for temporary and permanent medical exemptions if applicable.

4. What are the different parts of Form 680?

   Form 680 consists of three main parts:

   • Part A: This section confirms that the child has received all required immunizations for school attendance.
   • Part B: This part is for children who have started their immunization schedule but are not yet fully vaccinated. It includes a temporary medical exemption.
   • Part C: This section is for children who cannot receive certain vaccines due to medical reasons, providing space for documentation of the exemptions.

5. How do I complete Form 680?

   To complete Form 680, parents or guardians should gather the child's immunization records. Enter the required information in the appropriate sections, including vaccine dates and codes. After filling out the form, sign and date the certificate. It is essential to review the records carefully to ensure accuracy.

6. What should I do if my child has not received all required immunizations?

   If your child has not completed their immunization schedule, you can still fill out Form 680. In this case, you will need to complete Part B, indicating that your child has commenced the required vaccinations. The form should be updated as your child receives additional immunizations.

7. Are there exemptions to the immunization requirements?

   Yes, there are exemptions available. Form 680 includes options for temporary and permanent medical exemptions. A temporary exemption may be granted if a child is in the process of receiving vaccinations but has not yet completed them. A permanent exemption can be issued for valid medical reasons, which must be documented by a physician or authorized clinic.

8. Where can I find additional information about completing Form 680?

   For more detailed instructions on completing Form 680, you can refer to the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes. This document is available at www.immunizeflorida.org/schoolguide.pdf. It provides comprehensive guidance on immunization requirements and form completion.

Here are eight common misconceptions about the Florida 680 form, which certifies immunization for school attendance:

1. The 680 form is only for K-12 students. This form is applicable for children in daycare, preschool, kindergarten, and grades 1 through 12.
2. All immunizations must be completed before submitting the form. The form allows for temporary medical exemptions and incomplete immunization schedules, provided they are documented correctly.
3. The child's Social Security Number is mandatory. The child's SSN is optional on the form, and parents can choose not to provide it.
4. Only a doctor can sign the 680 form. The form can also be signed by authorized clinic personnel, not just physicians.
5. Once submitted, the 680 form is permanent. The immunization records can be updated, and parents should ensure they keep them current as their child receives additional vaccinations.
6. The 680 form is the only documentation needed for school enrollment. Some schools may require additional paperwork or proof of immunization, so it's important to check with the specific school.
7. Immunization records are not verified. Schools typically verify the information on the 680 form to ensure compliance with state requirements.
8. All vaccines must be listed on the form. Only the vaccines required for school attendance need to be documented; other vaccinations are not necessary for the form.

1. Failing to include complete names of the child and parent or guardian. It is essential to provide the last name, first name, and middle initial for proper identification.

2. Not entering the date of birth in the correct format. The form requires the date to be entered as MM/DD/YY, and any deviation from this format can lead to processing delays.

3. Omitting the immunization dates. Each dose must have a corresponding date filled out in the designated areas. Missing dates can result in incomplete records.

4. Incorrectly selecting the certificate type. Ensure the appropriate certificate (A, B, or C) is signed and dated. An incorrect selection may invalidate the submission.

5. Neglecting to provide expiration dates for temporary medical exemptions. Without an expiration date, the exemption is considered invalid.

6. Not including the physician or clinic name and authorized signature. This information is crucial for verifying the immunization records and ensuring compliance with legal requirements.

7. Failing to review the immunization records before submission. It is important to ensure that all information is accurate and complete to avoid complications with school attendance.

The Florida Certificate of Immunization (Form 680) is similar to the CDC's Immunization Record. Both documents serve to track an individual's immunization history. The CDC record is often used nationwide, while the Florida form is specific to the state. Each document includes sections for listing vaccines received, dates administered, and the provider's signature. This ensures that schools and childcare facilities can verify that a child has met the necessary immunization requirements.

Another document comparable to the Form 680 is the School Health Immunization Form. This form is utilized by various states to confirm that students have received the required vaccinations before attending school. Like the Florida Certificate, it outlines the specific vaccines needed for school entry and allows for exemptions. Both documents aim to promote public health by ensuring that children are protected against preventable diseases.

The Immunization Exemption Form is also similar to the Form 680, particularly in its handling of medical exemptions. This form allows parents to declare that their child cannot receive certain vaccines due to medical reasons. It requires documentation from a healthcare provider, similar to the permanent medical exemption section of the Florida Certificate. Both forms emphasize the importance of maintaining accurate health records while accommodating individual health needs.

The Health Department Immunization Record is another document that parallels the Form 680. This record is often issued by local health departments and contains details about a person's vaccination history. Both records serve the same purpose of providing proof of immunization and are accepted by schools and childcare facilities. They help ensure that children are protected from infectious diseases in community settings.

When considering important legal documents for healthcare decisions, the Florida Medical Power of Attorney form stands out as a crucial instrument. This form allows individuals to appoint someone they trust to make medical decisions on their behalf. For more information, explore the comprehensive Medical Power of Attorney guidelines.

The Vaccination Card, often provided by healthcare providers, shares similarities with the Form 680. It lists the vaccines administered, along with the dates and provider information. While the vaccination card is more informal, it serves the same function of documenting immunizations. Both documents are crucial for parents to maintain and present when required for school enrollment or other activities.

Lastly, the Child Health Assessment Form is comparable to the Form 680 in that it includes immunization records as part of a broader health evaluation. This form assesses various aspects of a child's health and development, including vaccinations. Both documents aim to ensure that children receive the necessary health care to thrive and prevent the spread of diseases in schools and communities.