Doh january 2026

1. Click ‘Get Form’ to open the Certificate of Immunization Status (CIS) in the editor.
2. Begin by entering your child’s last name, first name, middle initial, and birthdate in the designated fields.
3. Indicate whether you give permission for your child’s school or childcare to add immunization information into the Immunization Information System by checking the appropriate box.
4. If applicable, acknowledge conditional status by checking the box and ensure you provide required documentation by established deadlines.
5. Fill in the date columns for each vaccine received using MM/DD/YY format. Refer to the provided guides for correct vaccine names if necessary.
6. For verification of chickenpox disease or immunity, have a health care provider complete and sign the Documentation of Disease Immunity section.
7. Finally, ensure all required signatures are obtained from both parent/guardian and health care provider before submitting the form.

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