Fill a Valid 680 Form

How to Use 680

Filling out the Florida Certification of Immunization, commonly referred to as Form DH 680, is a crucial step for ensuring your child is up to date with their immunizations before attending school, childcare, or family daycare homes in Florida. This form acts as a record of your child's vaccinations. Following the correct steps to complete this form will help streamline the process for both parents and educational or childcare institutions. It's important to complete this form accurately to comply with Florida's immunization requirements. Here's how to go about it:

1. Start by entering the child's last name, first name, and middle initial (MI), followed by the Date of Birth (DOB) in the format MM/DD/YY.
2. If you choose to, add the Parent or Guardian's name, the child’s Social Security Number (SSN) (optional), and the State Immunization ID# (optional).
3. Consult your child’s immunization record to accurately fill in the VACCINE section. For each vaccine listed, enter the dates (MM/DD/YY) when your child received their doses. Note that some vaccines have up to 5 doses, so fill in as many as applicable.
4. Under each vaccine, there is a DOE Code associated. Make sure you enter the right codes for the vaccines your child has received. These codes are crucial for the form's processing.
5. Choose the correct certificate for your child’s situation:
   • Part A - Complete this part if all K-12 immunizations, excluding 7th grade/middle school requirements, are complete. Check the box next to "Immunizations are complete K-12 (Excluding 7th grade/middle school requirements)" or "Immunizations are complete for 7th grade" as applicable.
   • Part B - This is for children who are incomplete for immunizations required in Part A and are on a schedule to complete them. You must provide an expiration date for the temporary medical exemption.
   • Part C - Use this part for any medically contraindicated immunizations, listing each vaccine and providing a reason for the exemption.
6. The form must be signed and dated by a physician or authorized clinic staff at the bottom, where it says Physician or Clinic Name and Authorized Signature.
7. Finally, ensure the form is issued by the correct authority and contains all the necessary dates and signatures to be valid.

Once completed, this form serves as an official document verifying your child's immunization status. Make sure to keep a copy for your records and submit the original to the necessary educational or childcare institution. Accurate completion and timely submission of the Form DH 680 can prevent any delays in your child's enrollment and attendance.

What is the DH 680 form used for in Florida?

The DH 680 form, also known as the Florida Certification of Immunization, is a document used to certify that an individual, typically a child, has received the immunizations required for school attendance, childcare facilities, and family daycare homes in Florida. It records the dates of vaccination doses and specifies if the immunization schedule is complete or if there are temporary or permanent medical exemptions.

Who needs to complete the DH 680 form?

This form must be completed by the parent or guardian of a child enrolling in a Florida school (from kindergarten through 12th grade), or enrolling in childcare facilities, family daycare homes, and preschool programs. It is also necessary for those who are seeking temporary or permanent medical exemptions from the required vaccinations.

What information is required on the DH 680 form?

The form requires the child's name, date of birth, parent or guardian's information, and optional information such as the child's Social Security Number and State Immunization ID Number. It also requires the documentation of all appropriate doses of required vaccines, their dates, and the signing and dating of the appropriate certification (A, B, or C) on the form.

Can the DH 680 form be completed without a Social Security Number?

Yes, providing the child's Social Security Number is optional on the DH 680 form. The form can be completed and processed without it. However, including it may help with the identification process and records management.

Where can I obtain the DH 680 form?

The DH 680 form is typically provided by healthcare providers in Florida who administer the vaccines. It can also be obtained from local health departments, or the form and guidelines for its completion can be found online at the Florida Health Department's website dedicated to immunization information.

What happens if a child does not complete the required immunizations?

If a child has not completed the required immunizations, they can still be enrolled temporarily under Part B of the form, which certifies that the child has received some immunizations and has commenced a schedule to complete the required immunization. This enrollment is valid only till the expiration date set on the form, by which the remaining vaccinations must be administered.

What is a Permanent Medical Exemption, and how is it documented?

A Permanent Medical Exemption (Part C of the form) indicates that one or more required immunizations are medically contraindicated for the child due to their physical condition. This part must list each exempt vaccine and include valid clinical reasoning or evidence for the exemption, certified by a physician or authorized clinic personnel.

Is the DH 680 form the same as a personal immunization record?

While the DH 680 form does document the vaccinations a child has received, it is specifically designed to certify compliance with Florida's school and childcare immunization requirements. It is an official document that must be signed by a healthcare provider, differentiating it from a personal immunization record, which serves as a more informal record of an individual's vaccinations.

Filling out the Florida Certification of Immunization (Form DH 680) accurately is essential for ensuring that students meet the state’s vaccination requirements for school and childcare facilities. However, many people make mistakes during this process. Acknowledging these common errors can help in avoiding them:

1. Incorrect or Incomplete Vaccine Dates: One common mistake is entering incorrect dates or leaving the vaccine dates section blank. Each vaccine dose must be accompanied by the correct date (MM/DD/YY) it was administered.
2. Omitting the DOE Codes: Failing to select and enter the appropriate Department of Education (DOE) code that corresponds with the student’s immunization status is a frequent error. These codes are crucial for identifying the vaccination requirements the student meets.
3. Leaving Optional Fields Blank When Applicable: While the child’s Social Security Number and the State Immunization ID# are labeled as optional, if this information is available, it should be included to ensure accurate identification and record-keeping.
4. Incomplete Vaccine Information: Not fully completing the vaccine sections, including missing doses or not listing all required vaccines, can lead to unnecessary follow-ups or delays in processing.
5. Misunderstanding Temporary vs. Permanent Medical Exemptions: A clear distinction between temporary and permanent medical exemptions is often overlooked. Ensure the right section is completed accurately to reflect the child’s medical exemption status.
6. Forgetting to Sign and Date the Form: Failing to sign and date the form at the bottom is a common oversight that can invalidate the document.
7. Not Reviewing the Immunization Guidelines: The instructions and guidelines provided at the link mentioned in the form are frequently ignored. Reviewing these can prevent mistakes related to form completion and vaccine requirements.
8. Incorrectly Listing Vaccine Types: Mixing up vaccines or incorrectly listing them (e.g., DTaP vs. Tdap) can lead to confusion about the student’s immunization status.
9. Failure to Specify Varicella Disease: For children who have had the chickenpox (varicella) and are thus exempt from the vaccine, incorrectly documenting this information or leaving it blank is a common mistake. The year of the disease should be accurately listed.
10. Using Outdated Forms: Utilizing an outdated version of the DH 680 form can lead to discrepancies, as immunization requirements and form structures may change over time.

By avoiding these common mistakes, parents, guardians, and healthcare providers can ensure the DH 680 form is filled out correctly and efficiently, facilitating a smoother process for school and childcare admissions in Florida.

When managing immunization records and health documentation for school or daycare entry in Florida, the DH 680 Form, also known as the Florida Certification of Immunization, is a crucial document. However, it often comes hand-in-hand with other forms and documents to ensure a comprehensive health and immunization profile for the individual. The following outlines additional forms and documents commonly used alongside the DH 680 Form to provide a more complete health documentation package.

• DH 3040 Form - This is the Florida School Entry Health Exam Form, required for children entering a Florida school for the first time. It documents that a child has received a physical examination by a U.S. licensed doctor within the past year.
• DH 3203 Form - The Florida Immunization Record Form, used as a personal immunization record. Parents and individuals keep this form for their records, typically updated with each vaccine received.
• Certificate of Religious Exemption (DH 681 Form) - This form is used if immunizations are against the religious beliefs of the child or the child’s parents or guardians. It must be obtained from a local county health department.
• Vaccine Information Statements (VIS) - Provided with each vaccination, these statements inform about the benefits and risks of a vaccine before it is administered.
• Birth Certificate - Often required alongside health forms to verify the child's age and identity.
• Proof of Residence - May be needed for school registration alongside health forms to verify the child's residential eligibility for school attendance.
• Social Security Card - Sometimes requested for registration purposes alongside health documentation.
• Emergency Contact and Medical Information Forms - Schools and daycare facilities require this form to have contact information in case of emergencies and to be aware of any special medical conditions or needs.
• Previous School Records - For students transferring from another school, academic and sometimes health records are required to ensure proper placement and that all health requirements are met.

Together, these documents support the DH 680 Form in creating a comprehensive profile of a student’s health, immunization status, and readiness for entry into Florida’s educational institutions. Ensuring that all relevant documentation is complete and up-to-date facilitates a smoother enrollment process and helps maintain a safe and healthy school environment for all students.

The 680 Form, known as the Florida Certification of Immunization, shares similarities with several other documents that track health, vaccination, or regulatory compliance. One such document is the CDC's Vaccine Administration Record for Children and Teens. This record, like the 680 Form, is designed to document all vaccinations received by an individual, ensuring they meet the required standards for school enrollment and participation in various activities. It includes spaces for dates of vaccinations, the type of vaccine administered, and the healthcare provider's details, closely mirroring the structure and intent of the 680 Form.

Another document similar to the 680 Form is the International Certificate of Vaccination or Prophylaxis. Issued by the World Health Organization, this certificate is often required for international travel, proving that the traveler has received vaccinations against diseases prevalent in certain regions, such as Yellow Fever. This document, like the 680 Form, serves as an official record of vaccination, but it is tailored for global health requirements rather than school enrollment.

The Medical Exemption Form for Vaccinations is also akin to the 680 Form, particularly to its Part C, which pertains to permanent medical exemptions. Both documents require a healthcare professional's certification that the individual has a medical condition that contraindicates vaccinations. The key difference lies in their focus; while the 680 Form provides a comprehensive record of immunizations alongside exemption information, the Medical Exemption Form strictly addresses the exemption aspect.

The Immunization Information Systems (IIS) Participation Agreement is another related document, though it is more about the system that tracks vaccinations than a vaccination record itself. Like the 680 Form, this agreement plays a critical role in managing public health by ensuring accurate and comprehensive immunization data is collected and shared among healthcare providers, schools, and public health officials, promoting efficient tracking of vaccination coverage and exemption statuses.

Similarly, the Vaccine Adverse Event Reporting System (VAERS) form parallels the 680 Form in its contribution to public health monitoring. While the 680 Form records the immunization status to fulfill school entry requirements, the VAERS form is used to report any adverse effects following vaccination. Both forms support the overarching goal of safe and effective vaccine use, albeit from different angles: one from administration and compliance, and the other from post-vaccination monitoring.

Last but not least, the Vaccine Exemption Form for Religious or Philosophical Reasons shares its essence with part of the Florida Certification of Immunization. This form allows individuals to declare exemption from vaccinations due to personal beliefs, similar to how Part B and Part C of the 680 Form accommodate exemptions for medical reasons. Both documents underscore the balance between public health mandates and individual liberties, ensuring that exemptions are well-documented and based on valid reasoning.

Filling out the Florida Certification of Immunization (Form 680) is a crucial step in ensuring children meet the state's immunization requirements for school and daycare enrollment. Here are several key dos and don'ts to help you accurately complete the form.

• Review the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes before filling out the form to ensure you understand the requirements.
• Enter all vaccine doses and dates in the format MM/DD/YY as requested on the form.
• Make sure to fill in the child's full name, date of birth, and the parent or guardian's name to prevent any issues with form processing.
• For optional fields like the child's Social Security Number and State Immunization ID#, consider providing this information if available, as it may help the health department keep better track of the immunization record.
• Choose the appropriate certificate (A, B, or C) based on the child's immunization status and accurately sign and date the form.
• Consult with a healthcare provider to ensure that all information about vaccine doses is accurate.
• Keep a copy of the completed form for your records and provide the original to the necessary school or childcare facility.

• Do not leave any required fields blank. If a section does not apply, clearly mark it as "N/A" (Not Applicable).
• Avoid guessing vaccine dates or doses; only enter verified information to prevent inaccuracies in the child's health records.
• Do not forget to sign and date the form, as an unsigned form is considered incomplete and invalid.
• Refrain from using pencil or erasable ink; all entries should be made in permanent ink to ensure the form remains legible and official.
• Do not ignore the temporary or permanent medical exemption sections if they apply to the child. These parts must be completed accurately to ensure compliance with state laws.
• Never submit the form without reviewing it for errors or missing information, which could delay processing.
• Avoid holding onto the form for too long after completion; promptly provide it to the necessary educational or childcare institution.

There are several misunderstandings about the Florida Certification of Immunization, also known as the DH 680 form. Here's a list of common misconceptions and clarifications:

• Misconception 1: The child's Social Security Number is required. Clarification: Providing the child's Social Security Number is optional.
• Misconception 2: All children must have the same immunizations, regardless of their situation. Clarification: Some children may have temporary or permanent medical exemptions for certain immunizations.
• Misconception 3: The form doesn't need updating once completed. Clarification: The form should be updated as children receive additional vaccinations or as their immunization status changes.
• Misconception 4: Parents or guardians can sign off on the immunizations themselves. Clarification: A physician or authorized clinic staff must certify the form.
• Misconception 5: There's only one type of certificate on the form. Clarification: There are three parts to the certificate - Part A for complete K-12 immunizations (except 7th grade), Part B for temporary exemptions, and Part C for permanent exemptions.
• Misconception 6: The form is valid indefinitely once signed. Clarification: The Temporary Medical Exemption has an expiration date and must be renewed accordingly.
• Misconception 7: If immunizations are complete, no further documentation is needed. Clarification: Even if immunizations are complete, the form still needs to be properly signed and dated by the certifying physician or clinic staffer.
• Misconception 8: The form covers immunizations for college attendance. Clarification: The DH 680 form is specifically for K-12 school attendance, excluding college or university requirements.

Understanding the specifics of the DH 680 form helps ensure that children are properly immunized for school attendance while accurately reflecting any exemptions due to medical conditions.

Filling out and utilizing the Florida Certification of Immunization (Form 680) accurately is crucial for ensuring your child’s compliance with immunization requirements for school and daycare enrollment. Here are six key takeaways to guide you through this process:

• Understand Legal Requirements: The Form 680 is mandated by Sections 1003.22, 402.305, 402.313, Florida Statutes, and Rule 64D-3.046, Florida Administrative Code, ensuring students meet immunization standards for attending school.
• Complete Information: Provide full details including the child's name, date of birth, and optional information like the child’s Social Security Number and State Immunization ID#. This ensures the form is associated correctly with your child.
• Record Immunization Dates: Accurately enter all doses of required vaccines administered, including the date (MM/DD/YY) for each. This includes vaccines like DTaP/DTP, Polio, MMR, Hepatitis B, and Varicella among others.
• Select the Correct Certificate: Sign and date the appropriate section for your child - Part A for complete K-12 immunizations (excluding 7th grade requirements), Part B for temporary medical exemptions, or Part C for permanent medical exemptions, based on the vaccinations your child has received.
• Temporary vs. Permanent Medical Exemptions: Understand the difference between a temporary and a permanent medical exemption. Temporary exemptions require a completion schedule for required immunizations, whereas permanent exemptions require documentation of valid clinical reasoning or evidence for the exemption.
• Refer to Guidelines: Consult the DH Form 150-615, Immunization Guidelines - Florida Schools, Childcare Facilities, and Family Daycare Homes for detailed instructions on form completion. This document is available online and provides comprehensive guidance.

Ensuring the Form 680 is filled out accurately and completely is essential for smooth enrollment processes in Florida schools and childcare facilities. Always double-check entries for accuracy and keep up-to-date records of your child's immunizations.