Kci form 2026

1. Click ‘Get Form’ to open the kci form in the editor.
2. Begin by entering the student's name, county, ethnicity, race, and sex. Ensure all fields are filled accurately as this information is crucial for record-keeping.
3. Input the birthdate in the format MM/DD/YYYY. This helps establish the age of the student for vaccination requirements.
4. Record each vaccine dose received by filling in the corresponding columns for DTaP, Polio, HEP B, Varicella, MMR, and others as applicable. If a dose is deemed invalid by a provider, mark it accordingly.
5. For any additional doses added later, initial next to the dose and provide your signature at the bottom of the documentation section.
6. Complete the legal alternatives section if applicable. Ensure that any exemptions are documented correctly according to Kansas law.
7. Finally, have an authorized representative sign and date the form to validate it before submission.

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