F 04002 2025

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The document outlines the requirements for Wisconsin schools to report student immunization compliance to local health departments for the 2017-2018 school year. It specifies that all students through grade 12 must provide evidence of vaccination or a signed waiver, and schools must submit aggregate compliance data by the 40th school day. The form includes sections for school identification, student categorization based on immunization status, and instructions for reporting.

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Click ‘Get Form’ to open the F-04002 in the editor.
In Section A, enter the contact information for your school. This includes the DPI LEA (District) Code, DPI School Code, and the grades enrolled. Use our platform's search feature to find these codes easily.
Move to Section B and list the number of students in each category from rows 1 through 7. Ensure that each student is counted only once in a category. Remember, row 8 must equal the total enrollment for all grades included.
In Section C, report any students who have received no immunizations and have a waiver for all vaccines. Fill this out for both Kindergarten students and all students enrolled at your school.
Review all entries for accuracy before submitting. Once completed, you can easily save or send the form directly from our platform.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (105 Votes)
2015	4.2 Satisfied (58 Votes)
2008	4.2 Satisfied (38 Votes)

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Can you get immunization records from Mychart?

Go to My Record Health Summary and select the Immunizations tab. You can see the immunizations youve received and the dates on which you received them. Click the immunization name to learn more. If your immunizations are not up to date, please reach out to your clinic directly to have your information updated.

How do I look up my immunization records in Wisconsin?

Go to . Near the bottom of the page, within the Public Immunization Record Access, Click the Public Immunization Record Access link. On the next screen, enter your or your childs first name in the First Name field and last name in the Last Name field.

How do I find my immunization records in Wisconsin?

Go to the Wisconsin Immunization Registry (WIR) website. Once you are in WIR, look for the title Public Immunization Record Access. Inside the box underneath, click on the Public Immunization Record Access link. In the Immunzation Record Search screen, type in the first and last name and birth date of your child.

What is a copy of your immunization records?

Vaccination records (sometimes called immunization records) provide a history of all the vaccines you or your child received. This record may be required for certain jobs, travel abroad, or school registration.

Do you have to be vaccinated to go to public school in Wisconsin?

To protect students and children from diseases that are preventable by immunization, Wisconsin law requires all students to show that they have received the required immunizations or have a signed waiver. National Center for Immunizations.

Is it illegal to not vaccinate your child in Wisconsin?

Parents Responsibility A note from your childs health care provider is sufficient. Failure to meet Wisconsins immunization requirements is AGAINST THE LAW. If you fail to comply with the law, you may be fined up to $25 per day, and your child may be excluded from child care or school.

When did the Wisconsin immunization registry begin?

WIR supports the Wisconsin Immunization Program activities including the Vaccines for Children (VFC) and Vaccines for Adults (VFA) programs. WIR assists with vaccine preventable disease outbreak response. WIR became available for statewide release in May 2000.

Is there a religious exemption for vaccines in Wisconsin?

In Wisconsin, if a parent refuses to vaccinate their child, they may seek either a religious waiver or a personal conviction waiver.

F 04002 2025

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How to use or fill out f 04002 with our platform

See more f 04002 versions

Complete this form in 5 minutes or less

Got questions?

Can you get immunization records from Mychart?

How do I look up my immunization records in Wisconsin?

How do I find my immunization records in Wisconsin?

What is a copy of your immunization records?

Do you have to be vaccinated to go to public school in Wisconsin?

Complete this form in 5 minutes or less

People also ask

Is it illegal to not vaccinate your child in Wisconsin?

When did the Wisconsin immunization registry begin?

Is there a religious exemption for vaccines in Wisconsin?

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F 04002 2025

Here's how it works

How to use or fill out f 04002 with our platform

See more f 04002 versions

Complete this form in 5 minutes or less

Got questions?

Can you get immunization records from Mychart?

How do I look up my immunization records in Wisconsin?

How do I find my immunization records in Wisconsin?

What is a copy of your immunization records?

Do you have to be vaccinated to go to public school in Wisconsin?

Related Searches

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Complete this form in 5 minutes or less

People also ask

Is it illegal to not vaccinate your child in Wisconsin?

When did the Wisconsin immunization registry begin?

Is there a religious exemption for vaccines in Wisconsin?

Related links

Try more PDF tools