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This record is part of the student's permanent record and shall be transferred from one school to another as defined in Section 72-6262 (d) of the Kansas School Immunization Law (amended 1994-2026
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How to Use or Fill Out the Kansas Certificate of Immunizations (KCI)
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- Click 'Get Form' to open it in the editor.
- Begin by entering the student's name in the designated field at the top of the form.
- Fill in the county and ethnicity fields as required.
- Select the sex of the student by checking either 'MALE' or 'FEMALE'.
- Input the birthdate in MM/DD/YYYY format.
- Record each vaccine dose received by filling out the corresponding columns for each vaccine listed, ensuring to note any invalid doses as indicated.
- If additional doses are added, initial next to those doses and provide your signature below.
- Complete the documentation section by having a physician or authorized representative sign and date it.
- Finally, ensure that all information is accurate before saving or exporting your completed form.
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