Official 680 Form in PDF

The 680 form, officially known as the Florida Certification of Immunization, is a document required for school attendance in Florida. It serves to verify that a child has received the necessary immunizations as mandated by state law. This form is essential for ensuring the health and safety of children in educational settings.

Open 680 Online

The Florida Certification of Immunization, commonly referred to as the 680 form, plays a crucial role in ensuring that children meet the immunization requirements for school attendance in Florida. This form is mandated by various sections of the Florida Statutes and is essential for parents and guardians to document their child's vaccination history. The form requires the entry of specific immunization doses along with corresponding dates, allowing for a clear record of compliance with state regulations. It includes multiple sections, each designed to cater to different scenarios: Part A confirms that a child has received all necessary immunizations for K-12 schooling, Part B addresses temporary exemptions for those who have not yet completed their vaccination schedule, and Part C outlines permanent medical exemptions for children who cannot receive certain vaccines due to medical reasons. Parents must ensure that the form is completed accurately, signed, and dated, as it serves not only as a record for schools but also as a safeguard for public health. Comprehensive guidelines for filling out the form can be found in the Immunization Guidelines for Florida Schools, which are accessible online, providing further clarity on the process. Understanding the significance and requirements of the 680 form is vital for parents navigating the immunization landscape in Florida.

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Key takeaways

Here are key takeaways for filling out and using the Florida Certification of Immunization Form (680):

Complete all sections: Ensure that you fill in the child's last name, first name, middle initial, date of birth, and parent or guardian details.
Immunization records: Enter all relevant vaccine doses and their respective dates in the provided fields.
Certificate selection: Choose the appropriate certificate (A, B, or C) based on the child's immunization status.
Temporary exemptions: If applicable, fill out Part B for temporary medical exemptions, ensuring you include an expiration date.
Permanent exemptions: Use Part C to document any permanent medical exemptions, providing valid clinical reasoning.
Authorized signature: Ensure that the form is signed by a physician or authorized clinic representative to validate the immunization records.
Submission: Submit the completed form to the appropriate educational institution or childcare facility as required.
Guidelines reference: Consult the Immunization Guidelines for Florida Schools and Childcare Facilities for additional instructions and information.

Form Breakdown

Fact Name	Details
Legal Authority	The Florida Certification of Immunization 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.
Child Information	The form requires the child's last name, first name, middle initial, and date of birth.
Parent/Guardian Details	It is necessary to include the name of the parent or guardian and the child's Social Security number, though the latter is optional.
Immunization Records	Parents must enter the dates for all appropriate doses of vaccines in the designated fields on the form.
Certificate Types	There are three types of certificates: Part A for complete immunizations, Part B for temporary exemptions, and Part C for permanent medical exemptions.
Expiration Dates	For temporary medical exemptions, an expiration date must be provided; otherwise, the exemption is invalid.
Physician's Role	A physician or authorized clinic must sign the form, certifying the child's immunization status or medical exemption.
Form Updates	The current version of the form is dated July 2010, indicating that it may be subject to updates or revisions.
Access to Guidelines	Additional information and guidelines for completing the form can be found at www.immunizeflorida.org/schoolguide.pdf.

Documents used along the form

The Florida Certification of Immunization (Form 680) is a crucial document for children attending school or daycare in Florida. Along with this form, several other documents may be required to ensure compliance with state regulations. Below are four additional forms that are often used in conjunction with the 680 form.

DH Form 150-615: This form provides comprehensive immunization guidelines for Florida schools, childcare facilities, and family daycare homes. It outlines the necessary immunizations required for school attendance and offers instructions on how to properly complete the 680 form.
Durable Power of Attorney Form: A critical document for managing financial matters on behalf of another, especially during medical incapacitation. For a comprehensive guide and template, refer to All New York Forms.
Certificate of Medical Exemption: This certificate is issued when a child cannot receive certain vaccinations due to medical reasons. It must include the specific vaccines that are contraindicated and the clinical reasoning behind the exemption. This document ensures that children with valid medical concerns are still able to attend school.
Health Assessment Form: This form is often required by schools to assess a child's overall health and readiness for school. It may include information about the child's medical history, current medications, and any allergies. This assessment helps schools ensure that children are healthy and safe in the learning environment.
Proof of Residency: Schools often require documentation that verifies a child's residency within the district. This can include utility bills, lease agreements, or other official documents. Proof of residency is essential for enrollment and ensures that children are attending the appropriate school.

Each of these documents plays a vital role in the enrollment process and helps maintain the health and safety of all students. It is important to gather and submit these forms promptly to avoid any delays in school attendance.