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The Florida Certification of Immunization, commonly referred to as the 680 form, plays a crucial role in ensuring that children meet the state’s immunization requirements for school attendance. This form is governed by several legal authorities, including sections of the Florida Statutes and administrative rules. It is essential for parents or guardians to provide accurate information, including the child's name, date of birth, and immunization history. The form requires documentation of various vaccines, such as DTaP, MMR, and Hepatitis B, along with the corresponding dates of administration. Additionally, it includes sections for certifying the completion of immunizations, requesting temporary exemptions, or noting permanent medical exemptions. Each section must be signed by a physician or authorized clinic representative, underscoring the importance of professional validation in the immunization process. For detailed instructions on completing the form, parents can refer to the Immunization Guidelines available through the Florida Department of Health. This form not only helps safeguard public health but also ensures that children can participate fully in educational opportunities.

Similar forms

  • Florida Certificate of Health: Similar to the 680 form, this document certifies that a child is in good health and has received necessary vaccinations. It may be required for school enrollment.
  • Immunization Record: This document provides a detailed history of vaccinations received by an individual. Like the 680 form, it includes dates and types of vaccines administered.
  • School Health Assessment Form: This form is often required for school entry. It includes health information and immunization status, similar to the 680 form.
  • Medical Exemption Form: This document is used when a child cannot receive certain vaccines for medical reasons. It parallels the 680 form’s sections on temporary and permanent medical exemptions.
  • Childhood Immunization Schedule: This schedule outlines recommended vaccination timelines. It serves a similar purpose to the 680 form by ensuring children receive necessary immunizations on time.
  • Vaccine Information Statement (VIS): This statement provides information about vaccines. It complements the 680 form by educating parents on the benefits and risks of vaccines.

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  • Enrollment Form for Daycare or School: This form collects essential information about a child, including immunization records. It shares similarities with the 680 form in gathering necessary health data for school attendance.

Form Properties

Fact Name Description
Legal Authority The form is governed by Sections 1003.22, 402.305, and 402.313 of the Florida Statutes, as well as Rule 64D-3.046 of the Florida Administrative Code.
Purpose This form certifies that a child has received the required immunizations for school attendance in Florida.
Information Required It requires the child's name, date of birth, parent or guardian information, and immunization details.
Exemptions There are options for temporary and permanent medical exemptions, with specific documentation needed.
Completion Guidelines Instructions for completing the form can be found in DH Form 150-615, available at www.immunizeflorida.org/schoolguide.pdf.
Validity The form is invalid without the required signatures and dates, ensuring it is properly completed.

How to Use 680

Completing the Florida Certification of Immunization (Form 680) is essential for ensuring that a child meets the immunization requirements for school attendance. The form requires accurate information about the child's immunization history, and it must be signed by a qualified individual. Follow these steps carefully to fill out the form correctly.

  1. Begin by entering the child's last name, first name, and middle initial in the designated fields.
  2. Input the child's date of birth in the format MM/DD/YY.
  3. Provide the name of the parent or guardian.
  4. If applicable, include the child's Social Security number and state immunization ID number in the optional fields.
  5. Locate the section for vaccine doses. For each vaccine listed, enter the dates of administration for Dose 1 through Dose 5 in the MM/DD/YY format.
  6. Choose the appropriate certificate box (A, B, or C) based on the child's immunization status:
    • Part A for complete immunizations.
    • Part B for temporary exemptions.
    • Part C for permanent medical exemptions.
  7. If selecting Part B or Part C, provide any required details, such as expiration dates or medical reasoning.
  8. Ensure that the physician or clinic name is filled out, along with the authorized signature.
  9. Finally, include the date when the form is completed.

Key takeaways

Here are some key takeaways to keep in mind when filling out and using the Florida Certification of Immunization (Form 680):

  1. Complete All Required Information: Ensure that you fill in all necessary fields, including the child's full name, date of birth, and immunization details. Missing information can lead to delays in processing.
  2. Accurate Documentation: Record each vaccine dose and date accurately. Double-check the dates to confirm that they are in the correct format (MM/DD/YY).
  3. Choose the Correct Certificate: Sign and date the appropriate certificate (A, B, or C) based on the child's immunization status. This is crucial for compliance with school and daycare requirements.
  4. Understand Exemptions: If applicable, be aware of the conditions for temporary or permanent medical exemptions. Provide valid clinical reasoning or evidence to support these exemptions.
  5. Stay Informed: Refer to the Immunization Guidelines provided by the Florida Department of Health for detailed instructions. You can find these guidelines online at www.immunizeflorida.org/schoolguide.pdf.

Following these guidelines will help ensure a smooth experience when submitting the 680 form for school or daycare enrollment.

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Documents used along the form

The Florida Certification of Immunization, commonly known as the 680 form, is an essential document for students entering school. However, it is often accompanied by other forms and documents that provide additional context or fulfill specific requirements. Below are four important documents that are frequently used alongside the 680 form.

  • DH Form 150-615: This document provides detailed immunization guidelines for Florida schools, childcare facilities, and family daycare homes. It outlines the necessary immunizations for various age groups and offers instructions for completing the 680 form.
  • New York Mobile Home Bill of Sale: This legal document is crucial for transferring ownership of a mobile home, detailing the sale price and conditions. For a comprehensive template, visit mypdfform.com/blank-new-york-mobile-home-bill-of-sale.
  • Temporary Medical Exemption Form: This form is used when a child cannot receive certain vaccinations due to medical reasons. It must include an expiration date and is essential for ensuring that children can still attend school while awaiting their immunizations.
  • Permanent Medical Exemption Form: This document is for children who are medically contraindicated from receiving specific vaccines. It requires a physician's signature and must clearly state the clinical reasoning for the exemption.
  • Health Assessment Form: Often required for school entry, this form provides a comprehensive overview of a child's health status. It may include information about previous illnesses, allergies, and any ongoing medical conditions that could affect immunization schedules.

Understanding these accompanying documents is crucial for parents and guardians. They help ensure that children meet the necessary health requirements for school attendance while also safeguarding their well-being.

Discover More on This Form

  1. What is the purpose of the Florida 680 form?

    The Florida 680 form, also known as the Certification of Immunization, is used to document a child's immunization history. Schools and childcare facilities in Florida require this form to ensure that children are up-to-date on their vaccinations, which is essential for public health and safety.

  2. Who needs to fill out the 680 form?

    Parents or guardians of children who are entering school or daycare facilities in Florida must fill out the 680 form. This includes children in preschool, kindergarten, and grades 1 through 12. It is also necessary for children who are transferring from another school or who are new to the state.

  3. What information is required on the form?

    The form requires the following information:

    • Child's last name, first name, and middle initial
    • Date of birth
    • Parent or guardian's name
    • Child's Social Security number (optional)
    • State immunization ID number (optional)
    • Details of each vaccine received, including doses and dates

  4. How do I complete the form?

    To complete the form, enter the appropriate doses and dates for each vaccine in the designated sections. After filling out the information, sign and date the appropriate certificate (A, B, or C) on the form. For more detailed instructions, refer to the Immunization Guidelines available at the Florida Department of Health's website.

  5. What are the different parts of the 680 form?

    The 680 form has three main parts:

    • Part A: Certification for K-12 students, confirming that immunizations are complete.
    • Part B: Temporary certification for children who have started their immunization schedule but are not fully vaccinated yet.
    • Part C: Permanent medical exemption for children who cannot receive certain vaccines due to medical reasons.

  6. What should I do if my child has a medical exemption?

    If your child has a medical exemption, you will need to complete Part C of the form. This section requires a healthcare provider to certify that the immunizations are medically contraindicated. Be sure to provide valid clinical reasoning or evidence for the exemption.

  7. Is there a deadline for submitting the 680 form?

    Yes, the 680 form should be submitted before the child starts school or daycare. Each institution may have its own specific deadline, so it’s important to check with the school or facility for their requirements. Generally, submitting the form well in advance of the school year is advisable.

  8. Can I obtain a copy of the 680 form online?

    Yes, you can download a copy of the Florida 680 form from the Florida Department of Health's website. It is important to ensure you are using the most current version of the form, as it may be updated periodically.

  9. What if my child is not up-to-date on vaccinations?

    If your child is not up-to-date on vaccinations, you can still fill out Part B of the form. This part allows you to certify that your child has begun their immunization schedule. You will need to provide a plan for completing the required vaccinations.