Portuguese Certificate of Immunization Status form - doh wa 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the child's surname, first name, middle initial, date of birth (mm/dd/yyyy), and sex in the designated fields at the top of the form.
3. Fill in the vaccination details for each vaccine received. For each entry, specify the vaccine type under 'Vacina', and record the dose dates in the corresponding month, day, and year columns.
4. If your child has had chickenpox instead of receiving the vaccine, select one of the four options provided to confirm this history. Ensure that any necessary documentation is attached.
5. Complete any additional sections regarding immunity verification if applicable. This may require a health professional's signature and laboratory reports.
6. Finally, sign and date the form in the upper right corner before submitting it to your child's school or daycare.

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