CERTIFICATE OF IMMUNIZATION STATUS - Brighton School 2026

1. Click ‘Get Form’ to open the Certificate of Immunization Status in the editor.
2. Begin by entering the child's last name, first name, and middle name in the designated fields.
3. Fill in the parent or guardian's name, along with their daytime phone number and the child's birthdate.
4. In the immunization section, record each vaccine type administered along with the date given. Ensure you include details for Hepatitis B, MMR, DTaP/DTP/DT, and Varicella.
5. If applicable, indicate any exemptions by checking 'YES' or 'NO' and provide necessary documentation if claiming a medical exemption.
6. Finally, certify that all information is correct by signing at the bottom of the form and entering the date.

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