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Click ‘Get Form’ to open the washington state CIS form fillable 2011 in our platform.
Begin by entering your child’s last name, first name, middle initial, birthdate, and sex in the designated fields at the top of the form.
In the vaccine section, record each vaccine your child has received. For each vaccine type, fill in the corresponding date and dose information under the 'Vaccine', 'Month', 'Day', and 'Year' columns.
If applicable, indicate if your child has had chickenpox disease by selecting one of the four options provided. Ensure you provide any necessary documentation as specified.
Complete the certification section by signing and dating where indicated. This confirms that all information is accurate and verifiable.
Finally, review all entries for accuracy before saving or printing your completed form to submit it to school or childcare.
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