Free 680 PDF Form

What is the DH 680 form used for in Florida?

The DH 680 form, also known as the Florida Certification of Immunization, is a comprehensive record used to document the vaccines a child has received. It's a mandatory form for children attending school, childcare, and family daycare homes in Florida, as it verifies that a child has been immunized according to the state's requirements. This form plays a critical role in ensuring public health safety by reducing the spread of vaccine-preventable diseases within educational and childcare settings.

How can a parent or guardian obtain the DH 680 form?

Parents or guardians can obtain the DH 680 form from their child's healthcare provider or local health department. The form must be completed by a healthcare professional who has access to the child's vaccination records. Additionally, some healthcare providers might offer the option to complete this form online through Florida's State Health Online Tracking System (SHOTS), making the process more convenient and accessible.

What information must be provided on the DH 680 form?

On the DH 680 form, it's necessary to enter detailed information regarding the child's immunization history. This includes the child's full name, date of birth, parent or guardian's details, and optional information such as the child's Social Security Number and State Immunization ID#. For each vaccine received, the form requires details about the doses, including the date each dose was administered. Additionally, the healthcare provider must select the appropriate certification section (A, B, or C) based on the child's immunization status and sign the form to validate it.

Are there exemptions available for the immunization requirements?

Yes, Florida allows for certain exemptions to the immunization requirements for school and childcare entry. These exemptions are documented in Parts B and C of the DH 680 form. Part B covers Temporary Medical Exemptions, where a child is given a timeline to meet the immunization requirements if unable to be fully vaccinated immediately due to medical reasons. Part C covers Permanent Medical Exemptions, for situations where specific vaccines are contraindicated due to the child's medical condition. All exemptions require documentation by a licensed physician and must include valid clinical reasoning or evidence.

Can the DH 680 form be transferred between states if moving?

While the DH 680 form is specific to Florida, most states have similar immunization documentation requirements for school and childcare enrollment. If a family is moving out of Florida, it's advisable to obtain a copy of the completed DH 680 form from the child's healthcare provider. This document can then be presented to the new state's health department or educational institution to assist in the transfer process and help establish the child's immunization history in line with the new state's requirements.

What is the validity period of the DH 680 form?

The DH 680 form does not have a stated expiration date and remains valid as long as the child's immunization status complies with Florida's current requirements. However, updates or additional forms may be needed if new immunization requirements are introduced by the state or if the child receives further vaccinations. It's essential for parents or guardians to maintain updated records, particularly when approaching key educational milestones, such as entering 7th grade, where additional vaccine requirements come into effect.

1. One common mistake is not double-checking the child's personal information, including the last name, first name, and date of birth (DOB). This basic information is critical for identifying the record correctly and ensuring that the immunization data matches the child it belongs to.

2. Another error occurs when people overlook the optional sections for the child’s Social Security Number (SS#) and State Immunization ID#. While these are not mandatory, providing them can help in maintaining accurate immunization records across different healthcare systems.

3. Failing to enter all relevant vaccine dose dates is also a frequent oversight. Each vaccine listed on the form has spaces for multiple doses - Dose 1 to Dose 5 - and omitting any can give an incomplete picture of a child's immunization status.

4. People often mistakenly select the wrong DOE Code for the Certificate of Immunization section. The form distinguishes between complete immunizations for K-12 excluding 7th grade (DOE Code 1) and complete for 7th grade (DOE Code 8), which has specific requirements.

5. Not providing a signature and date on the appropriate certificate section is another common mistake. Whether it is Part A, B, or C, a signature and date are essential for the form’s validity.

6. Forgetting to list specific vaccines under the Permanent Medical Exemption part is a significant error. This section requires detailed information on each exempt vaccine and the valid clinical reasoning or evidence supporting the exemption.

7. Not including an expiration date in the Temporary Medical Exemption section renders Part B of the form invalid. This date is crucial for determining the period during which the child is exempt from specific immunizations.

8. For those filling out the form based on a review of records, failing to provide an accurate review statement in the certifying statement section can lead to misinformation. It’s important to affirm that the immunizations have been adequately completed for school attendance as documented.

9. Lastly, overlooking the availability of the Immunization Guidelines - Florida Schools, Childcare Facilities, and Family Daycare Homes which provide detailed instructions for form completion, can result in multiple errors. Not consulting these guidelines can lead to misunderstandings about the requirements and how to properly fill out the form.

When submitting the Florida Certification of Immunization (DH 680), other forms and documents often supplement the application process, ensuring compliance with state and school district requirements. These documents, each serving a distinct purpose, range from consent forms to medical histories, allowing for a comprehensive understanding of the student's health and immunization status. Below is a list of such forms and documents that are commonly used alongside the DH 680 form.

• DH Form 150-615, Immunization Guidelines: This document provides detailed guidelines for immunization requirements within Florida schools, childcare facilities, and family daycare homes, offering instructions for the completion of the DH 680 form.
• Physical Examination Form: A record of a physical exam, often required for new students or those participating in sports, indicating the child's fitness for school and physical activities.
• Birth Certificate: Used to verify the student's age and identity. This is a basic document required for enrollment in most schools.
• Consent for Treatment Form: Authorizes the school to make medical decisions or provide treatments in emergencies when parents or guardians cannot be reached.
• Medical History Form: Offers a comprehensive view of the student's health history, including past illnesses, surgeries, allergies, and medications, which might affect immunization schedules or school participation.
• Vaccine Information Statements (VISs): Federally produced information sheets that explain the benefits and risks of a vaccine to vaccine recipients or their guardians.
• Exemption Declaration Form: For declaring medical or religious exemptions from certain immunizations, detailing the reasons for exemption and often requiring a physician’s signature for medical exemptions.
• Proof of Previous Immunizations: A record of vaccines the student has received prior to the current enrollment, ensuring that the student meets state immunization requirements.
• Student Enrollment/Registration Form: A general form for enrolling a child in school, which includes sections for personal detail and health information.
• Emergency Contact Form: Lists contacts authorized to pick up the student from school or to be notified in case of an emergency, including health emergencies.

Together with the DH 680 form, these documents form a comprehensive packet that schools and health authorities use to safeguard the health of Florida’s student population. They ensure that all children enrolled in public and private institutions are protected against vaccine-preventable diseases, in line with state laws and the broader public health mission.

• The Vaccine Information Statement (VIS) is similar to the DH 680 form in that both provide critical information about vaccinations. The VIS explains the benefits and risks of a vaccine before it is administered, similar to how the DH 680 form documents the vaccinations a person has received or needs, ensuring the individual or guardian is informed about their immunization status.

• The International Certificate of Vaccination or Prophylaxis (ICVP) shares similarities with the DH 680 form, particularly in its purpose of recording vaccines. While the DH 680 is focused on school and daycare compliance within Florida, the ICVP is used globally to provide proof of vaccination against diseases like yellow fever, necessary for entry into certain countries.

• A Medical Exemption Certificate is akin to the DH 680 form’s Part C, where medical exemptions for vaccines are documented. Both serve as official records that some or all vaccines are medically contraindicated for the individual, based on health reasons, and are recognized by schools and healthcare providers.

• The Immunization Registry Records, such as those maintained by state health departments, are comparable to the documentation aspect of the DH 680 form. These registries track a person’s immunizations throughout their life, similar to how the DH 680 records vaccinations for school or childcare requirements.

• School Entry Health Exam Certification forms, required for enrollment in many schools, share a goal with the DH 680 form: to ensure child wellness for school participation. Both include sections on immunization status, though the health exam certification also covers other aspects of a child’s health beyond vaccinations.

• Childcare Enrollment Health Form is similar to the DH 680 form in its function for verifying children's health and immunization status before they enter a childcare setting. Both forms ensure that children meet health and immunization requirements, protecting the wellbeing of all children in the facility.

When filling out the Florida Certification of Immunization, or Form 680, it's important to follow specific guidelines to ensure the form is completed accurately and effectively. Below are lists of things you should do and things you shouldn't do during this process:

• Do review the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes available at www.immunizeflorida.org/schoolguide.pdf before starting the form to understand the requirements.
• Do fill out the child's name, date of birth, parent or guardian's information, and optional fields such as the child's Social Security Number and State Immunization ID# if available.
• Do accurately enter all appropriate doses and their dates for each vaccine listed in the form.
• Do select the appropriate certificate (A, B, or C) based on the child's immunization status and fill out the corresponding section as instructed.
• Do ensure that the physician or clinic's name is clearly printed, and that the form has the authorized signature and issue date completed.
• Don't leave any required fields blank. If a section does not apply, make sure to indicate this appropriately as per the instructions.
• Don't guess or approximate vaccine dates. Use accurate records to avoid issues with school or childcare facility admissions.
• Don't sign the form without thoroughly reviewing all the information entered for accuracy and completeness.
• Don't forget to check if additional documentation is required by the school, childcare, or family daycare home for exemptions or incomplete immunizations.

By carefully following these guidelines, you can help ensure the Form 680 is filled out correctly, supporting a smooth process for verifying the child's immunization status for school or childcare attendance in Florida.

Understanding the Florida Certification of Immunization, commonly referred to as the DH 680 form, is essential for parents, guardians, and educational administrators. However, misconceptions often surround its requirements and implications. Let's clarify some common misunderstandings:

• Misconception 1: The child's Social Security number is required.
  

  Many believe providing a child's Social Security number on the DH 680 form is mandatory. In reality, this is optional. The form states both the child’s Social Security number and the state immunization ID# as optional, aiming to protect privacy while ensuring immunization tracking.

• Misconception 2: All immunizations must be completed before submission.
  

  A common misunderstanding is that the DH 680 form can only be submitted once all immunizations are completed. However, there are provisions for temporary and medical exemptions, allowing for submission under incomplete immunization schedules. For example, Part B is specifically for children who are in the process of completing their immunizations, highlighting the form's flexibility.

• Misconception 3: The form is only applicable for public school attendance.
  

  It's often thought that the DH 680 form only applies to children attending public schools. However, the legal authority cited includes requirements for childcare facilities, family daycare homes, and preschools, in addition to K-12 public schools, illustrating the form's broader applicability.

• Misconception 4: The form is valid indefinitely once submitted.
  

  Some believe that once the DH 680 form is submitted, it remains valid indefinitely. This is not the case for temporary medical exemptions, as these carry an expiration date and must be updated accordingly. The form explicitly states that temporary exemptions are invalid without an expiration date, emphasizing the need for ongoing verification.

• Misconception 5: Physician signatures are not necessary for permanent medical exemptions.
  

  There is a misconception that permanent medical exemptions can be granted without a physician or clinic's direct involvement. In contrast, Part C of the form requires detailed information on medically contraindicated immunizations, including "valid clinical reasoning or evidence for exemption," and mandates a physician or authorized clinic signature, reinforcing the importance of medical assessment in these exemptions.

Clearing up these misconceptions ensures that individuals can navigate the requirements of the DH 680 form more effectively, promoting better public health practices while accommodating individual needs.

Filling out and using the Florida Certification of Immunization (Form 680) can seem daunting at first. However, understanding a few key takeaways can make the process smoother and ensure that your child meets the state's requirements for school and childcare facility attendance. Here are six important points to remember:

• Legal Framework: The requirement for this form is backed by Sections 1003.22, 402.305, 402.313 of the Florida Statutes, and Rule 64D-3.046 of the Florida Administrative Code. This legal grounding emphasizes the importance of adhering to the state's immunization guidelines for all students and children in childcare settings.
• Comprehensive Documentation: The form requires detailed information about the child's immunization history, including the dates of all the relevant doses for vaccines like DTaP/DTP, polio, MMR, hepatitis B, and varicella, among others. Accurate records are crucial for compliance and for protecting the health of the child and the public.
• Optional Information: It's important to note that the child’s Social Security Number (SSN) and the State Immunization ID# are optional. While providing these details can aid in maintaining and accessing immunization records, parents and guardians have the option to omit this information if they have privacy concerns.
• Different Parts for Different Needs: The form is designed with three parts (A, B, and C) to address various immunization statuses. Part A is for children whose immunizations are complete, Part B caters to children on a temporary immunization schedule, and Part C is for exemptions due to medical reasons. Understanding which part to complete is essential based on the child’s current immunization status.
• Medical Exemptions: For children who cannot be immunized due to medical contraindications, Part C of the form allows for a permanent medical exemption. Each vaccine from which the child is exempt must be listed along with valid clinical reasoning or evidence supporting the exemption. This underscores the necessity for accurate medical documentation.
• Verification and Signature: A physician’s or authorized clinic's signature is required to validate the immunization information or exemption stated on the form. This step is vital for the form to be considered official and valid for school or childcare attendance in Florida. Always ensure that this section is duly filled and signed by the appropriate healthcare professional.

By keeping these key points in mind, completing the Florida Certification of Immunization (Form 680) can be a streamlined process. More importantly, it ensures that children are protected against vaccine-preventable diseases as they enter school or childcare facilities, contributing to the health and safety of the entire community.