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California immunization record yellow card pdf

Yellow immunization card pdf 2025

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The document is an immunization record form from the California Department of Public Health, detailing patient information, vaccine history, and eligibility for the Vaccines for Children (VFC) program. It includes sections for recording various vaccines administered, their dates, manufacturers, and lot numbers, as well as known allergies and reactions to vaccines. The form emphasizes the importance of providing Vaccine Information Statements (VIS) to patients before vaccination.

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Click ‘Get Form’ to open the yellow immunization card PDF in the editor.
Begin by entering the patient's name in the designated field, including last name, first name, and middle initial.
Fill in the birthdate of the patient accurately to ensure proper record keeping.
Select the gender by checking either 'Male' or 'Female'.
Indicate any known reactions to vaccines or allergies in the provided section.
Complete the practice name and address fields for accurate documentation.
For VFC eligibility, check one of the options that apply to your situation.
Record each vaccine administered by filling out details such as date given, manufacturer and lot number, site of administration, and who administered it. Ensure you circle the appropriate vaccine type.

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How long is a Yellow Card valid?

International Certificates of Vaccination or Prophylaxis (ICVP) are available for purchase in quantity from the Government Printing Office bookstore. Individual copies are not available. To order, please visit U.S. Government Bookstore or call toll-free (866) 512-1800.

What is a yellow vaccine?

Generally recommended for all travelers over 9 months of age. Required if arriving from a region with yellow fever.

How do I order yellow immunization cards in California?

To order the California Immunization Card (Yellow), please call The Immunization Project at (213) 351-7800. Quantity: Billing materials are ordered through the State and will arrive within 6-8 weeks. (Please limit your order to a 2-3 month supply.) Health Centers (FQHCs), and Rural Health Clinics.

What is the yellow card in the US?

The yellow fever vaccination card, also known as the yellow card (Carte Jaune), is a physical vaccine card that is used to show that someone has been vaccinated against yellow fever.

What is a yellow Vaccination card?

Known popularly as the Carte Jaune or Yellow Card, this is the international certificate of vaccination (ICV) approved by the World Health Organization.