Form 3231-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the child's name in the designated field, ensuring you follow the format of last name first.
3. Fill in the parent/guardian's name, again using the last name first format. This is crucial for identification purposes.
4. Complete the immunization history section by entering dates for each vaccine received. Remember, dates are required for children aged 4 years and older.
5. If applicable, indicate any exemptions by filling in the appropriate sections regarding natural immunity or medical exemptions.
6. Ensure that a licensed physician or health department official certifies the document by providing their printed name, address, and telephone number.
7. Finally, sign and date the certificate to validate it. Make sure all required fields are completed before saving your document.

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