The immunization certification form (DHMH ) or a printed or a computer generated immunization record form and the required immunizations must be. DHMH , Rev. 4/ Center for Immunization: MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE IMMUNIZATION. About this Form. Form number: DHMH Audience: Students. Last revised: September Adobe PDF Maryland Department of Health Immunization.

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Foreign exchange students are required to meet Maryland Immunization requirements. Immunization records shall be made available to the Garrett County Health Officer or designee as needed for review when necessary.

Washington County Public Schools

I am coming from out of state, will the immunization record from my state allow my child to start school? Immunizations violate our religious beliefs, can my child attend school? Dhmmh the blood titer does not show immunity, the child must then still receive another immunization. What if my child has had some of the immunizations, but not all, can they start school? Previous Next Section Table of Contents. The form should be marked with the code Immunization. What if my doctor is out of the vaccine?

Are foreign exchange students required to have proof of immunizations? If the student, parent, or guardian presents evidence of an appointment with a health care provider or health department to:.

If the condition is temporary, the doctor must include when 8896 child will be able to receive the vaccination.

Form Detail – Montgomery County Public Schools, Rockville, MD

This document is updated each school year and is available at www. The school Nurses assigned to the schools will continually check the immunization records of all students who are not in compliance.


Signature, title, and date of the physician, health official, school official, or regulated child care program providing the information on the form. The principal, school nurse, or designee shall be responsible for certifying that it contains the following information: If your child has at least one of each, they may begin school as long as the school has proof of an appointment within 20 days of the start of school or the earliest date the vaccine may be given.

Reconstruct a lost or destroyed record; or c. If your child does not meet Maryland requirements, you will be given a time frame to meet Maryland requirements. When such a student has not followed the prescribed immunization schedule, the School Nurse will notify the principal. Signature, title, and date of the physician, health official, or school official. If the contraindication is temporary:. A preschool or school, public or private, may count as valid, vaccine doses administered less than or equal to 4 days before the minimum interval or age.

The school nurse or designee will compile a list of students with medical and religious wavers. What if my child received their first MMR or Varicella prior to their first birthday?

Parent notification letter, PS40will be used for this purpose. If the contraindication is temporary: If the student, parent, or guardian presents evidence of an appointment with a health care provider or health department to: The date of the chmh may not be later than 20 calendar days following the date the student was temporarily admitted or retained.


Receive a required immunization; b. You must present proof of the immunizations to the school the next day after the appointment, or your child will be excluded from school until the school has verification of the immunizations. If your child is not immunized, they may be excluded from school if there is an outbreak of a vaccine preventable disease.

DHMH Immunization Certificate () Form – Documents | Washington County Public Schools

What if I cannot locate a copy of my child’s immunization record? This proof of the appointment must be given to the school on or prior to the first day your child starts. A school principal or other individual in charge of a school shall exclude a student who has been temporarily admitted or retained on the next school day following the appointment date if a student, parent, or guardian, fails to provide evidence of required immunizations or if a student reaches the twenty 20 -calendar days limit without showing proof of being in compliance, the student may not be permitted to attend school.

If you have the record from your previous state, that information will be transferred to a Maryland form by the school nurse and your child may start. Your child cannot start school without a record of their immunizations. The “exclusion” form should be distributed as follows: