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Certificate of immunization form

Tennessee immunization form 2026

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The document outlines the immunization requirements for children attending schools and child care facilities in Tennessee, effective from July 1, 2010. It details the necessary vaccines, exemptions, and documentation needed to ensure compliance with state law. The certificate must be completed by a qualified healthcare provider and includes sections for required and recommended vaccines, as well as provider assessments.

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Click ‘Get Form’ to open the Tennessee Immunization Form in our editor.
Begin by entering the child's name and birthdate in the designated fields at the top of the form.
In Section 1a, check the box for a religious exemption if applicable. If not, proceed to fill out Section 1b with health examination documentation, including dates and provider information.
Complete Section 2a by entering required vaccine dates. Ensure you follow the guidelines for each vaccine listed, marking them as completed.
In Section 3, select one option that best describes the child's immunization status. This is crucial for determining eligibility for school or childcare.
Finally, provide the printed or stamped name and contact details of a qualified healthcare provider in Section 4 before saving your completed form.

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What vaccines does Tennessee require?

What are Tennessees current school-entry vaccine mandates? Hepatitis B vaccine. Diphtheria-Tetanus-Pertussis vaccine (DTaP) Poliomyelitis vaccine. Haemophilus influenzae type B vaccine (Hib) Pneumococcal conjugate vaccine (PCV) Measles, Mumps, Rubella vaccines (MMR) Varicella (Chickenpox) vaccine. Hepatitis A vaccine.

What vaccines are required in Tennessee?

Children who are new enrollees in a TN school in grades other than Kindergarten Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate) Measles, Mumps, Rubella (2 doses of each, normally given together as MMR) Poliomyelitis (IPV or OPV) final dose on or after the 4th birthday now required.

Can unvaccinated kids go to public school in TN?

All students entering Metro Public School system must have a Tennessee Department of Health Immunization Certificate.

Which vaccines are actually needed?

Make an appointment for your child to get caught up if they havent received vaccines to protect against any of the following diseases: Chickenpox. Hepatitis A. Hepatitis B. Measles, mumps, and rubella. Polio. Tetanus, diphtheria, and whooping cough (pertussis)

Does Tennessee require the HPV vaccine?

Influenza (Flu) Vaccine: Recommended but not required. Human Papillomavirus (HPV) Vaccine: Recommended but not required. Primary Polio series: Recommended but not required. Tetanus, Diphtheria, and Pertussis Vaccine (Tdap): Recommended but not required.

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How to get a Tennessee immunization form?

To begin a TN immunization record request, please call the TDH at (615) 741-7247 and provide the following information about the person whose record is needed: Individuals full name (first, middle, and last name) Individuals maiden name and/or all previous last names. Individuals date of birth.