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Dhec 2740 form printable-2026

The South Carolina Certificate of Immunization (DHEC 2740) serves as official documentation of a child's immunizations required for daycare and school attendance in South Carolina. It outlines the process for certifying a child's vaccination status, including sections for recording vaccination dates, medical exemptions, and certification status. The document specifies the necessary information to be completed by healthcare providers and school nurses, ensuring compliance with state immunization requirements.

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Click ‘Get Form’ to open the DHEC 2740 form in our editor.
Begin by filling out Section 1: Identification/Name. Enter the child's full name, date of birth, and MCI/chart number if applicable.
Proceed to Section 2: Vaccination Date. Document the date for each immunization administered, ensuring to check the box for Varicella if applicable.
If there are any medical exemptions, complete Section 3. Ensure that this section is approved by a licensed physician or authorized representative.
In Section 4, provide the physician's information and signature. Make sure to include the facility's contact details and the date the certificate is issued.
Review all entries for accuracy before saving or printing your completed form.

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