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The 680 form, formally known as the Florida Certification of Immunization, plays a crucial role in ensuring that children meet the immunization requirements for school attendance in Florida. This form is governed by various legal authorities, including sections of the Florida Statutes and administrative rules. Parents or guardians must provide essential details such as the child's name, date of birth, and optional identification numbers. The form requires documentation of all relevant vaccine doses and dates, which must be entered accurately. Specific vaccines, including DTaP, Polio, MMR, and Hepatitis B, are listed with designated spaces for recording doses. There are three distinct parts to the form: Part A certifies that immunizations are complete, Part B allows for temporary exemptions, and Part C addresses permanent medical exemptions for contraindicated immunizations. Each section has specific codes and requirements, ensuring that the child's immunization status is clearly communicated. To assist with form completion, guidelines are available through the Florida Department of Health's resources. Understanding the 680 form is essential for parents navigating the immunization process for their children, particularly in the context of school enrollment.
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Documents used along the form
The Florida Certification of Immunization Form 680 is often accompanied by several other forms and documents that support the immunization process and school enrollment requirements. Below is a list of related documents commonly used in conjunction with 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 required for school attendance and offers instructions for completing the 680 form.
- Health Assessment Form: This form is typically required for new students entering a Florida school. It includes a physical examination report and may detail any health concerns or medical history relevant to the child's school environment.
- California Residential Lease Agreement: Understanding the terms and conditions outlined in the All California Forms is essential for ensuring a successful rental experience for both landlords and tenants.
- Medical Exemption Form: Used when a child cannot receive certain vaccinations due to medical reasons. This form must be completed by a licensed healthcare provider and should include specific details regarding the medical contraindications.
- Religious Exemption Form: This document allows parents to exempt their child from vaccinations based on religious beliefs. It requires a signed statement from the parent or guardian outlining their religious objections to immunizations.
- Emergency Contact Form: This form collects information on who to contact in case of an emergency involving the child at school. It is essential for ensuring the safety and well-being of the student.
- Enrollment Application: This document is necessary for enrolling a child in school. It typically includes personal information about the student and the parent or guardian, along with any required documentation, such as proof of residency and immunization records.
These documents work together to ensure that children meet health and safety standards before attending school. Proper completion and submission of these forms are crucial for compliance with Florida state regulations.
Form Breakdown
| Fact Name | Details |
|---|---|
| Legal Authority | Sections 1003.22, 402.305, 402.313, Florida Statutes; Rule 64D-3.046, Florida Administrative Code |
| Form Purpose | This form certifies that a child has received the required immunizations for school attendance in Florida. |
| Immunization Requirements | Immunizations must be documented for K-12 school attendance, with specific requirements for 7th grade. |
| Optional Information | Child's Social Security Number and State Immunization ID Number are optional fields on the form. |
| Completion Guidelines | Instructions for completing the form are available in DH Form 150-615 and online at www.immunizeflorida.org/schoolguide.pdf. |
| Exemptions | Temporary and permanent medical exemptions can be documented in Parts B and C of the form. |
| Signature Requirement | The form must be signed by a physician or authorized clinic representative to be valid. |
| Form Version | The current version of the form is DH 680, dated July 2010. |
More About 680
What is the Florida Certification of Immunization (Form 680)?
The Florida Certification of Immunization, commonly referred to as Form 680, is a document required for school enrollment in Florida. It certifies that a child has received the necessary vaccinations as mandated by state law. This form is essential for ensuring that children are protected against vaccine-preventable diseases and helps schools maintain a safe environment for all students.
Who needs to fill out Form 680?
Form 680 must be completed for all children entering K-12 schools in Florida. This includes children who are enrolling in preschool, kindergarten, or any grade up to 12. Additionally, children in daycare or family daycare homes also require this certification to ensure compliance with immunization requirements.
What information is required on Form 680?
The form requires basic information about the child, including their name, date of birth, and immunization history. Parents or guardians must enter the dates of each vaccination received. There are specific sections for various vaccines, and it is crucial to provide accurate details to reflect the child's immunization status correctly.
What are the different parts of Form 680?
Form 680 consists of three parts. Part A certifies that a child has completed all required immunizations for school attendance. Part B is for children who have not completed their immunizations but are on a schedule to do so. Part C is for children with permanent medical exemptions, where a physician must provide clinical reasoning for why immunizations are contraindicated.
How can I obtain Form 680?
Form 680 can be obtained from various sources. It is available at healthcare providers' offices, local health departments, and schools. Additionally, you can download the form from the Florida Department of Health's website or other relevant resources that provide immunization guidelines.
What should I do if my child has a temporary medical exemption?
If your child has a temporary medical exemption, you must complete Part B of Form 680. This section requires you to certify that your child has received some immunizations and is on a schedule to complete the remaining doses. Remember, this form must include an expiration date for the exemption to be valid.
What happens if I do not provide Form 680?
Failure to provide Form 680 may result in your child being unable to enroll in school or daycare. Schools are required to verify immunization records to protect the health of all students. It is vital to ensure that the form is completed accurately and submitted on time to avoid any disruptions in your child's education.
680: Usage Steps
Completing the Florida Certification of Immunization (Form 680) is essential for ensuring that a child meets the immunization requirements for school attendance. Follow the steps below to accurately fill out the form and submit it as needed.
- Obtain the Form 680 from a reliable source, such as a healthcare provider or the Florida Department of Health website.
- Fill in the child's last name, first name, middle initial, and date of birth in the designated fields.
- Enter the name of the parent or guardian in the appropriate section.
- If applicable, provide the child's Social Security number and state immunization ID number (both are optional).
- Document all relevant vaccine doses and dates in the provided table, ensuring to include the correct vaccine codes and corresponding dates.
- Select the appropriate certificate section (Part A, B, or C) based on the child's immunization status.
- For Part A, indicate if immunizations are complete by checking the appropriate box (DOE Code 1 or 8).
- For Part B, if applicable, complete the section for temporary exemptions, including the expiration date.
- For Part C, if applicable, provide details for permanent medical exemptions, including the physician's reasoning.
- Sign and date the form in the designated areas. Include the physician or clinic name and authorized signature if required.
After completing the form, ensure that all information is accurate and legible. Submit the form to the relevant school or childcare facility as part of the enrollment process. Keep a copy for your records.