Washington state immunization fillable form 2006-2026

1. Click ‘Get Form’ to open the Washington state immunization fillable form 2006 in the editor.
2. Begin by entering the child's last name, first name, and middle name in the designated fields at the top of the form.
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 received by the child. For each vaccine, enter the date given (month, day, year) and check off the appropriate dose.
5. If applicable, indicate any exemptions by checking 'YES' or 'NO' and provide details as required in the exemption section.
6. Complete the certification statement at the bottom of the form by signing and dating it to verify that all information is accurate.

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