680 Template

680: Usage Instruction

Completing the FLORIDA CERTIFICATION OF IMMUNIZATION form, also known as the 680 form, is an essential step for ensuring that your child meets the necessary immunization requirements for school. This process requires careful attention to detail, as inaccuracies can lead to complications with enrollment. The following steps provide a clear guide to help you fill out this important document correctly.

1. Obtain the 680 form. You can find it online or obtain a physical copy from your child’s school or healthcare provider.
2. Fill in personal information. In the designated spaces, enter the child’s last name, first name, middle initial, and date of birth (MM/DD/YY).
3. Provide parent or guardian details. Write the name of the parent or guardian along with the child’s social security number (optional) and state immunization ID number (optional).
4. Document vaccination information. For each vaccine listed, indicate the appropriate dose numbers and corresponding dates. Make sure to fill in all doses that the child has received.
5. Select the correct certificate type. Based on your child’s immunization status, check either Part A, Part B, or Part C. Ensure you are selecting the right option reflecting your child’s situation.
6. Certify the immunization status. If applicable, sign and date the appropriate certificate, affirming that the information provided is accurate to your knowledge.
7. For exemptions, provide additional information. If opting for a temporary or permanent medical exemption, ensure you provide the necessary details and rationale as required.
8. Submit the completed form. Once you have filled out the form, submit it to your child’s school or the designated authority in accordance with local guidelines.

Completing this form accurately contributes to a smoother enrollment process for your child. Ensuring that all details are correct and that the appropriate certificate is signed will help avoid any potential issues later on.

1. What is the 680 form?

   The 680 form, officially known as the Florida Certification of Immunization, is a document required for school enrollment in Florida. It certifies that a child has received the necessary immunizations as mandated by state law. This form ensures that children are protected against various contagious diseases and helps public health efforts in schools and childcare facilities.

2. Who needs to complete the 680 form?

   The 680 form must be completed for children entering school, daycare, or family daycare homes in Florida. This includes children in preschool, kindergarten, and grades 1 through 12. Parents or guardians are responsible for obtaining and submitting this form to ensure their child meets the immunization requirements.

3. What information do I need to provide on the 680 form?

   You will need to provide your child’s last name, first name, middle initial, date of birth, and, optionally, the child’s social security number and state immunization ID number. Additionally, the form requires you to list the immunizations received, along with the specific dates for each dose. If your child has a medical exemption, that information must also be included.

4. Are there exemptions to the immunization requirements?

   Yes, there are two types of exemptions you can apply for. A temporary medical exemption is available for those who are incomplete with their immunizations but are on a schedule to complete them. A permanent medical exemption can be issued for children whose medical conditions contraindicate certain vaccinations. Specific clinical reasoning must be provided by a physician or authorized clinic.

5. Where can I find guidelines for completing the 680 form?

   Guidelines for filling out the 680 form are available online. You can visit the Florida Department of Health’s website at www.immunizeflorida.org/schoolguide.pdf. This document provides detailed instructions and vaccination requirements for school attendance.

6. How do I submit the 680 form?

   After completing the 680 form, you should submit it to your child’s school or childcare facility. The form must be signed and dated for it to be valid. Ensure that it is submitted before your child's first day to avoid any issues with enrollment.

Filling out the Florida Certification of Immunization form, commonly known as the 680 form, can be straightforward, but many people make mistakes that can lead to delays or complications. Here are seven common errors to avoid.

One common mistake occurs when individuals fail to include the child's complete name. Always ensure that the last name, first name, and middle initial are fully entered. Missing or incorrect names can create confusion and slow down the processing of immunization records.

Additionally, missing or incorrect dates for the immunization doses is another frequent error. Each dose must have the accurate date of administration. Input MM/DD/YY format carefully to prevent misunderstandings regarding the immunization schedule.

Also, many forget to check the box for the appropriate certificate, whether it's Part A, B, or C. Selecting the wrong certificate can invalidate the entire submission, so review that section thoroughly before signing.

An optional section often overlooked is the child's Social Security Number. While it's not mandatory, it can help with record keeping. Leaving it blank may not always cause issues, but it can lead to complications in tracking the child's immunization history.

Not providing a valid expiration date for the Temporary Medical Exemption is another misstep. Without an expiration date, Part B becomes invalid. Always ensure that all sections are complete and accurate.

People also sometimes incorrectly interpret the immunization guidelines, leading to improper vaccine code entries. Each vaccine listed must match the documented doses above. Double-check your codes against the provided vaccine list to avoid errors.

Lastly, individuals may forget to obtain necessary signatures. All relevant parties must sign the form, including a physician or clinic representative. An unsigned form is incomplete and will not be accepted.

When preparing to submit the Florida Certification of Immunization (Form 680), several other documents may be useful in conjunction with it. Understanding these forms can help ensure a smooth process for enrolling your child in school or childcare. Here’s a brief overview of those commonly used documents.

• DH Form 150-615: This document contains the Immunization Guidelines for Florida schools, childcare facilities, and family daycare homes. It provides essential instructions on how to fill out the 680 form accurately and get your child enrolled.
• Florida Certificate of Immunization (Form DH 680C): Similar to the main 680 form, this certificate specifically caters to children attending public schools. It serves as proof of immunization compliance tailored for the school environment.
• DH Form 681: This is the Preschool and Daycare Program Immunization Record. It includes the required immunization information necessary for children enrolling in preschool or daycare facilities.
• Immunization Records from Healthcare Providers: Parents may need to present copies of their child’s immunization records from healthcare providers. These records detail all vaccines given and may help streamline the completion of the 680 form.
• Temporary Medical Exemption Letter: If applicable, this letter from a healthcare provider states why a child cannot receive certain vaccines temporarily. It validates the need for exemption due to medical reasons.
• Permanent Medical Exemption Letter: In cases where a child is permanently exempt from certain vaccines, this letter provides documentation from a physician explaining the medical basis for the exemption.

Collecting and understanding these documents can save time and reduce stress. They will provide the necessary support when submitting the Florida Certification of Immunization, ensuring your child receives the required immunizations for school or daycare attendance.

• Vaccination Record: Similar to form 680, a vaccination record documents all vaccines received by an individual. It also includes dates and types of vaccines just like the certification form.

• School Registration Form: This form collects personal information such as name and date of birth. Like the 680 form, it may require proof of immunization for enrollment.

• Health Assessment Form: Often required by schools, this form provides a summary of a child’s health status. It may ask for immunization information, much like the 680 form does.

• Sports Physical Form: Athletes may need to provide proof of immunization when participating in sports. This form serves a similar purpose as the 680 form in ensuring vaccination compliance.

• Childcare Enrollment Form: This document collects necessary information for enrollment in childcare. It typically requests immunization records, similar to what is required on the 680 form.

• Medical Exemption Form: For individuals unable to receive certain vaccinations, this form outlines reasons for exemption. Like Part C of the 680 form, it provides documentation for medical reasons.

• Immunization Record Request Form: Individuals may need to request their immunization records for various purposes. This form functions similarly by tracking vaccinations.

• International Certificate of Vaccination: Often required for travel, this certificate shows proof of vaccinations. It is similar in that it serves to document immunization status.

When filling out the Florida Certification of Immunization Form (680), here are some important dos and don’ts to keep in mind.

• Do fill in the last name, first name, and middle initial of the child accurately.
• Do provide the correct date of birth using the MM/DD/YY format.
• Do check the box for the appropriate certificate (A, B, or C) that applies to your situation.
• Do enter all doses and dates of immunization clearly to avoid confusion.
• Do make sure to sign and date the form before submitting it.
• Don’t leave any fields blank; incomplete forms can cause delays.
• Don’t provide unnecessary information; only fill in what is required.
• Don’t forget to check for spelling errors in names or dates.
• Don’t submit the form without reviewing it for accuracy first.

By following these guidelines, you can ensure that the form is filled out correctly, making the process smoother.

• Misconception 1: The 680 form is only for K-12 students.

This form is applicable to children in daycare, preschool, and through all grades up to 12, including requirements for 7th grade.

• Misconception 2: It is optional to submit the 680 form.

The 680 form is often required for school enrollment, making it essential for compliance with state immunization laws.

• Misconception 3: There is no expiration on the Temporary Medical Exemption.

A Temporary Medical Exemption must have a specified expiration date; without it, the exemption is invalid.

• Misconception 4: Parents can choose any vaccines for their child.

The immunizations listed on the form must meet state-specific requirements; they are not simply a matter of personal choice.

• Misconception 5: The 680 form can be completed without a physician’s input.

A licensed physician must review and sign the form, especially for medical exemptions.

• Misconception 6: All information on the 680 form is available on the internet.

While some guidelines are online, the personal details regarding your child's immunizations should be obtained directly from your healthcare provider.

• Misconception 7: You cannot update the 680 form once submitted.

Updates can be made if there are changes in your child’s immunization status; however, proper channels must be followed.

• Misconception 8: The 680 form applies to adults.

This form is specifically designed for children, as it pertains to their school and daycare immunization needs.

• Misconception 9: There is a single version of the 680 form.

There are multiple certificates (A, B, or C) based on the child’s immunization status, each serving different needs.

• Misconception 10: My child does not need the 680 form if they are home-schooled.

When filling out the Florida Certification of Immunization, or the 680 form, certain important considerations should guide the completion process.

• Accurate Information is Crucial: Ensure that all personal details, including the child's name, date of birth, and immunization history, are correctly entered. Mistakes may lead to delays in processing or issues with school enrollment.
• Complete the Appropriate Sections: Depending on the child's immunization status, select the right certificate section: Part A, B, or C. Part A is for complete immunizations, Part B for temporary exemptions, and Part C for permanent medical exemptions.
• Timeliness Matters: Pay attention to expiration dates when documenting temporary exemptions. The form cannot be considered valid without these dates included.
• Consult Guidelines: For clarity on specific requirements and completion instructions, reference the Immunization Guidelines available at the provided link. These resources can help ensure that the application is filled out in compliance with Florida’s regulations.

Understanding these key takeaways can significantly streamline the process and ensure that the 680 form is completed accurately, benefiting both the child and the educational institutions involved.