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Click ‘Get Form’ to open the dh form 684 in the editor.
Begin by filling in the Private School Information section. Enter the date, name of the school, and details of the person completing the form, including their address, city, zip code, county, principal's name, position/agency, and phone number.
In the Student Information section, list only those students who are not fully immunized for their grade. Indicate any type of exemption or compliance status for each student listed.
Complete the Summary Information section by providing totals for each category: students enrolled, fully immunized, medical exemptions (temporary and permanent), religious exemptions, and those out of compliance.
Once all sections are filled out accurately, review your entries for completeness before submitting. Save your document within our platform for easy access.
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Fla. Admin. Code Ann. R. 64D-3.046 | State Regulations
The report shall be completed on DH Form 684, Immunization Annual Report of Compliance for Kindergarten and Seventh Grade (July 2010), incorporated by referenceRead more
for Kindergarten and Seventh Grades (DH 684 Form): a. The Immunization Annual Report of Compliance for. Kindergarten and Seventh Grades (DH 684 Form) is sent.Read more
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