Fill Out Your 680 Form

Steps to Using 680

Filling out the Florida Certification of Immunization, also known as Form 680, is a crucial step in ensuring compliance with the state's vaccination requirements for school and daycare attendance. This process involves accurately recording immunization doses and dates, along with the necessary certifications related to the child's vaccination status. Following these detailed steps will guide you through the completion process smoothly and efficiently.

1. Gather the child's immunization records. Before you start, make sure you have all the necessary documents that record the child's vaccinations.
2. Enter the child's personal information. Fill in the child's last name, first name, middle initial (MI), date of birth (DOB) in the format MM/DD/YY, along with the parent or guardian's name. The child's Social Security Number (SSN) and State Immunization ID# are optional but may be required by some institutions.
3. Record vaccine doses and dates. Refer to the immunization records you gathered and enter all relevant doses and dates for each vaccine listed on the form. Make sure to use the correct format MM/DD/YY for all dates.
4. Choose the appropriate certificate. The form offers three options:
   • Certificate A for K-12 students (excluding 7th grade students) with complete immunizations.
   • Certificate B for temporary medical exemptions.
   • Certificate C for permanent medical exemptions.
   Select the one that applies to the child's situation.
5. Complete the certification section(s). Depending on your selection in step 4, fill in the required information for the chosen certificate type. For temporary exemptions, note the expiration date. For permanent exemptions, list each exempt vaccine and the clinical reasons for the exemption.
6. Physician or clinic verification. Have the form reviewed and signed by a physician or a representative from the clinic that provided the vaccinations. This verification is crucial for the form's validity.
7. Submit the form. Once completed and signed, submit the form to the child's school or daycare institution. Ensure you keep a copy for your records.

Once the form is submitted, the school or daycare facility will review the information to ensure it meets Florida's immunization requirements for enrollment and attendance. This step is critical for protecting the health and well-being of all students and faculty by preventing vaccine-preventable diseases. Should there be any issues with the form or further information required, the institution will reach out with specific instructions on how to proceed.

FAQs about the Florida Certification of Immunization (Form 680)

1. What is the Florida Certification of Immunization (Form 680)?

   Form 680 is a document that certifies a child's immunization history according to Florida's requirements for school and childcare facility attendance. It records the immunizations a child has received, including doses and dates, and indicates whether the immunization schedule is complete, in progress, or exempt due to medical reasons.

2. Who needs to complete Form 680?

   Parents or guardians of children enrolling in Florida schools, childcare facilities, and family daycare homes need to ensure this form is completed. It is essential for verifying that the child has met Florida's immunization requirements.

3. What vaccines are recorded on Form 680?

   The form includes spaces to record vaccinations for DTaP/DTP, Tdap, Td, Polio, Hib, MMR, Measles, Mumps, Rubella, Hepatitis B, Varicella, Varicella Disease, and PneumoConjugate.

4. How do I obtain Form 680 for my child?

   Form 680 can be obtained through your child's physician or local health department. After reviewing your child's immunization records, the healthcare provider will complete and sign the form.

5. Is it mandatory to provide a Social Security Number (SSN) on Form 680?

   No, providing a child's SSN on the form is optional. There is also an option to include a state immunization ID number, which is optional as well.

6. What are the different parts of Form 680?
   • Part A: Used when all required K-12 immunizations, except those for 7th grade/middle school, are complete.
   • Part B: Indicates a temporary medical exemption with a specific expiration date for children who have commenced a schedule to complete required immunizations but are not yet complete.
   • Part C: Indicates a permanent medical exemption for children for whom certain immunizations are medically contraindicated.
7. Can Form 680 be used for exemptions?

   Yes, Form 680 includes sections for both temporary and permanent medical exemptions (Parts B and C, respectively). The exemptions require valid clinical reasoning or evidence and must be signed by a physician or authorized clinic personnel.

8. What is the legal authority behind Form 680?

   Form 680 is backed by Sections 1003.22, 402.305, 402.313 of the Florida Statutes, and Rule 64D-3.046, Florida Administrative Code. These laws and regulations set the immunization requirements for children attending school and childcare facilities in Florida.

9. Where can I find the guidelines for completing Form 680?

   Guidelines for completing Form 680 are available in the DH Form 150-615, Immunization Guidelines - Florida Schools, Childcare Facilities, and Family Daycare Homes document. It provides detailed instructions and can be accessed online at www.immunizeflorida.org/schoolguide.pdf.

10. What should I do if I lose the Form 680?

    If you lose Form 680, contact the physician or clinic that issued the original form. They can provide a duplicate. You can also visit your local health department for assistance in obtaining a new form.

Filling out the Florida Certification of Immunization (Form DH 680) requires attention to detail and accuracy. However, individuals often make errors during this process, which can lead to delays or complications. Below are five common mistakes made when completing this form:

1. Failing to include all required doses and dates: Each vaccine has a specific dosage and schedule that must be accurately documented. Omitting doses or date information can render the form incomplete.

2. Overlooking the necessity to sign and date: The form mandates a signature and date in the appropriate section, certifying the accuracy of the information provided. This step is frequently missed, invalidating the submission.

3. Incorrect or incomplete personal information: The sections for last name, first name, middle initial (MI), date of birth (DOB), and, optionally, the child's social security number (SS#) and state immunization ID#, must be filled accurately. Mistakes or omissions in these fields can lead to identification issues.

4. Selection errors in certificate type: The form includes different parts (A, B, or C) that need to be completed based on the child's immunization status. Incorrectly selecting or neglecting the correct part correlates with the individual's situation can lead to processing errors.

5. Not referring to the Immunization Guidelines: The provided guidelines, available at the specified link, offer crucial instructions for form completion. Ignoring these guidelines can lead to mistakes in documenting the vaccines or understanding the form's requirements.

In summary, accuracy, thoroughness, and adherence to the provided instructions are critical when filling out the DH 680 form. Avoiding the mistakes listed above can facilitate a smoother process for certifying immunization compliance, which is essential for school and childcare attendance in Florida.

When it comes to ensuring health compliance for activities like school enrollment or participation in communal activities, the Florida Certification of Immunization (DH 680 Form) is often not the only document required. This pivotal form serves as a testament to a child's immunization against various diseases, playing a crucial role in public health. However, to provide a more comprehensive health profile, several other forms and documents might be required alongside it. These documents assist in painting a fuller picture of a child's health status and vaccination history.

• Proof of Physical Examination - This document verifies that the child has undergone a physical examination within the past 12 months. It assesses the child's overall health and fitness for school or daycare.
• Vision, Hearing, and Dental Screening Certificates - These screenings ensure that potential sensory or oral health issues are identified and addressed early, supporting a child's development and learning.
• Birth Certificate - Often required for initial registration, the birth certificate verifies a child's age, ensuring they receive immunizations appropriate for their age group.
• Exemption Forms - For children who cannot be vaccinated due to medical reasons or religious beliefs, exemption forms document the rationale behind the exemption and any alternative health precautions recommended.
• Immunization History Records - A detailed record from previous schools, daycares, or healthcare providers showing past immunizations can help healthcare professionals determine any missing vaccines and avoid duplicate administration.
• DH Form 150-615, Immunization Guidelines - Provides comprehensive guidelines on vaccine schedules and requirements for Florida's educational and childcare facilities, helping guardians ensure their child meets all necessary health standards.
• Proof of Varicella (Chickenpox) Immunity - If the child has had chickenpox, a documented history of the disease from a healthcare provider can sometimes substitute for vaccination.
• Documentation of Hepatitis B Vaccine Series Completion - Specific documentation may be required to confirm completion of the Hepatitis B vaccine series, due to its multi-dose schedule.
• Emergency Medical Information Form - Although not directly related to immunization, this form contains vital health information, including allergies and chronic conditions, ensuring school or daycare staff can respond appropriately in an emergency.

Together, these documents work in tandem with the DH 680 Form to ensure that children are not only immunized against common diseases but are also assessed for other health factors that could affect their educational journey. By providing a complete health dossier, parents and guardians play a crucial role in safeguarding not only their children's health but also the health of their communities.

The DH 680 form shares similarities with the CDC's Vaccine Information Statements (VIS). Both are public health documents designed to inform guardians about vaccines. The Florida Certification of Immunization (DH 680) records specific vaccine doses a child has received, while the VIS provides detailed information about the benefits and risks associated with each vaccine. Each document plays a crucial role in educating parents and ensuring children receive necessary immunizations for public health and safety. VIS complements the DH 680 by offering the necessary vaccine knowledge that supports the decisions documented on the form.

Similar to the DH 680 form, the I-693 form, Report of Medical Examination and Vaccination Record, is also health-related and used in a legal or regulatory context—this time for U.S. immigration purposes. It details an immigrant's vaccination status along with a medical examination to identify any conditions that might impact public health or safety. Both forms require a healthcare professional's certification, ensuring that individuals meet health-related legal or policy requirements (immunization for school enrollment in the case of DH 680 and medical fitness for immigration for I-693).

The Blue Card, or Personal Health Record, found in many states, serves a purpose akin to the DH 680, albeit in a broader health documentation capacity. This card normally includes immunization records among other health information, such as allergies and primary care details. The shared features between the Blue Card and DH 680 are the detailed recording of vaccines, though the Blue Card's scope is more extensive, enveloping a wider range of medical information beyond immunizations.

State-specific school entrance health assessment forms, similar to the DH 680, are designed to document a child's immunization status along with other health information required for school entry. These forms serve as a comprehensive report card of a child's health, including vision, hearing, and dental screenings, ensuring that children are not only current with their vaccines but are also generally healthy and ready for the school environment. The main similarity lies in the documentation of vaccinations as a critical component of school readiness.

The Yellow Card, or International Certificate of Vaccination or Prophylaxis, serves an international travel purpose that parallels the intent behind the DH 680. The Yellow Card documents vaccinations against diseases such as yellow fever, essential for entry into certain countries, mirroring the DH 680’s role in documenting immunizations for school entry requirements. Despite their different contexts—travel versus education—the core similarity is their function as official records of vaccination.

Medical exemption forms for vaccines, often state-specific, provide documented evidence of medical reasons why an individual cannot receive certain vaccines, akin to Part C of the DH 680 form. These forms, signed by healthcare professionals, detail why specific immunizations are contraindicated, aligning with the DH 680’s provision for noting medical exemptions within the immunization record, ensuring that individuals are not unnecessarily penalized for lacking certain vaccinations due to health reasons.

The Vaccine Administration Record (VAR) used in clinics and hospitals for documenting the administration of vaccines shares objectives with the DH 680 form. Both documents record details about vaccines given to an individual, including the date and type of vaccine. The VAR is typically used for a broader audience, not limited to school-aged children, underscoring its broader application in public health beyond the educational context.

The American Immunization Registry Association (AIRA) Minimum Data Set closely relates to the DH 680 in its function of standardizing immunization records. Though not a form per se, the AIRA Minimum Data Set specifies essential information to be collected in immunization registries, reflecting the detailed vaccine data captured in the DH 680. This standardization facilitates the efficient sharing and comparison of immunization information across systems and borders.

College immunization forms, much like the DH 680, require students to provide proof of vaccinations before being allowed to enroll. These forms typically ask for information on vaccines against diseases such as meningitis and measles, mirroring the DH 680's purpose in the K-12 setting. The primary objective is to safeguard the health of the student population by preventing vaccine-preventable diseases from spreading within crowded educational settings.

Finally, the Health Insurance Portability and Accountability Act (HIPAA) Authorization for Release of Health Information form, while broader in scope, intersects with the DH 680 form's functionality in terms of privacy and legal compliance. This authorization form allows healthcare providers to share an individual’s health information, including immunization records, with specified parties. Both forms navigate the delicate balance of maintaining an individual’s privacy while ensuring that crucial health information is appropriately shared for public health or personal health management purposes.

When filling out the Florida Certification of Immunization (DH 680) form, it’s essential to follow specific guidelines to ensure the form is completed correctly and accepted without issues. Here are some do’s and don'ts to consider:

• Do carefully read the immunization guidelines available at www.immunizeflorida.org/schoolguide.pdf before you start filling out the form. This can provide important details on form completion.
• Do double-check the personal information you enter, such as the child's name, date of birth, and the parent or guardian details, to ensure accuracy.
• Do enter all the appropriate doses and dates for each vaccine as accurately as possible. Misinformation can lead to unnecessary delays.
• Do sign and date the appropriate certificate (A, B, or C) on the form. Your signature is required to validate the form.
• Do consult with your healthcare provider if you’re unsure about any information that needs to be included on the form. They can provide accurate records and guidance.
• Don’t leave sections incomplete. If a section does not apply, such as the optional child's SSN or State Immunization ID#, make sure to indicate that it is intentionally left blank or mark it as not applicable (N/A).
• Don’t guess vaccination dates. If you're uncertain about the exact dates of immunizations, it's better to verify these with your healthcare provider than to risk incorrect information.
• Don’t forget to check for any temporary or permanent medical exemptions that need to be indicated on the form. Accurately completing these sections is crucial for compliance.
• Don’t neglect to keep a copy of the completed form for your records. Having a backup can be very helpful in case the original is lost or needs to be referenced in the future.

By following these do's and don'ts, you can help ensure that the process of completing the DH 680 form goes smoothly, making it easier for your child to meet Florida's immunization requirements for school attendance.

Many misconceptions surround the Florida Certification of Immunization, commonly referred to as the DH 680 form. These misunderstandings can lead to confusion and inaccuracies in immunization compliance for school and childcare admission. It's crucial to clarify these points to ensure all parties understand the requirements and implications of this form.

• Misconception 1: The DH 680 form is optional for school enrollment. Contrary to this belief, the DH 680 form is mandatory for enrollment in Florida schools, childcare facilities, and family daycare homes, ensuring that all children meet the state's immunization requirements.

• Misconception 2: A child's Social Security Number is required on the form. While the form has a space for the child's SSN, providing this information is optional, not a requirement for the form's submission or acceptance.

• Misconception 3: Only a physician can complete and sign the form. While it's true that a healthcare provider must certify the immunization status, this includes not only physicians but also other authorized healthcare professionals operating within their scope of practice.

• Misconception 4: The form is valid indefinitely once signed. In reality, the DH 680 form has different sections with varying validity periods. For example, the Temporary Medical Exemption must have an expiration date and is not valid indefinitely.

• Misconception 5: All immunizations listed on the form must be completed for school entry. This is not entirely accurate; the form accommodates exemptions, including medical exemptions documented by a healthcare provider and temporary medical exemptions allowing for a catch-up schedule.

• Misconception 6: Parental consent is not needed to complete the form. The parent or guardian's role is crucial in the process, from providing necessary information to understanding and consenting to the immunizations documented.

• Misconception 7: The DH 680 form can be submitted electronically in all cases. While digital submission options may be available, specific schools or facilities might require a hard copy. It's important to verify the acceptable submission methods with the respective institution.

• Misconception 8: The form does not accommodate varicella (chickenpox) disease immunity through previous infection. The form does have provisions for documenting varicella immunity through disease history, indicated by a healthcare provider's documentation.

• Misconception 9: The form applies only to public school students. The DH 680 form is applicable to students enrolling in both public and private schools in Florida, ensuring wide-ranging immunization compliance.

• Misconception 10: No further action is required once the form is completed and submitted. It's essential to maintain updated immunization records and submit a new DH 680 form if additional immunizations are administered or if a temporary medical exemption expires and is renewed.

Understanding these aspects of the DH 680 form is vital for parents, guardians, and education providers to ensure that all children are appropriately immunized for their safety and the safety of others in educational settings.

Filling out and using the 680 form, officially known as the Florida Certification of Immunization, requires careful attention to detail. Here are nine key takeaways to ensure compliance and accuracy:

• The legal basis for the 680 form falls under Sections 1003.22, 402.305, 402.313 of the Florida Statutes and Rule 64D-3.046 of the Florida Administrative Code, emphasizing its importance in the state's public health framework.
• Personal information including the child's last name, first name, middle initial, date of birth, parent or guardian's name, and optional details like the child's Social Security Number and State Immunization ID# must be accurately provided.
• Completion of the form entails entering all relevant immunization doses and their dates. This ensures that the child's vaccination records are up-to-date for school, childcare facilities, and family daycare homes.
• Signatories must select and sign the appropriate certificate (A, B, or C) on the form, which varies based on the child's current immunization status and specific needs.
• The document references the DH Form 150-615, Immunization Guidelines - Florida Schools, Childcare Facilities and Family Daycare Homes (July 2010), where detailed instructions for form completion are provided. Interested parties are encouraged to consult this guideline for comprehensive understanding and accuracy.
• There are distinct sections for various purposes: Certificate of Immunization for K-12 (Part A), Temporary Medical Exemption (Part B), and Permanent Medical Exemption (Part C), each addressing different conditions and requirements for immunization documentation.
• Temporary Medical Exemptions (Part B) are valid only with a specified expiration date, emphasizing the importance of timely follow-up vaccinations or reassessments.
• In cases of Permanent Medical Exemptions (Part C), detailed documentation of the specific vaccines contraindicated and the valid clinical reasoning or evidence for the exemption is mandatory.
• Every entry on the form, especially the signature from a physician or authorized clinic staff, is crucial, as it validates the information and ensures the form’s acceptance by schools and childcare facilities.

Ensuring the accurate and complete filling of the 680 form is pivotal for compliance with Florida's public health requirements, safeguarding not just the individual child's well-being but also the health of the broader community.