Certificate immunization 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 dates of each vaccine received in the corresponding columns using MM/DD/YY format. Refer to the provided reference guide for correct vaccine names if needed.
6. If your child has a history of chickenpox disease, ensure a health care provider verifies this and signs in the Documentation of Disease Immunity section.
7. Finally, sign and date where indicated as a parent or guardian, ensuring all information is accurate before submission.

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