Immunization Information Clause Samples
The Immunization Information clause establishes the requirements for collecting, maintaining, and sharing records related to immunizations. Typically, this clause outlines the types of immunization data that must be provided, the parties responsible for supplying or updating this information, and the circumstances under which such records may be disclosed, such as to health authorities or educational institutions. Its core function is to ensure that all relevant parties have access to accurate and up-to-date immunization records, thereby supporting compliance with public health regulations and facilitating safe participation in group settings.
Immunization Information licensee shall attach an enrolled child's written immunization record or exemption affidavit to the enrolled child's Emergency, Information and Immunization Record card.)
Immunization Information licensee shall attach an enrolled child's written immunization record or exemption affidavit to the enrolled child's Emergency, Information and Immunization Record card.) For information regarding current immunization requirements go to: ▇▇▇.▇▇▇▇▇.▇▇▇/▇▇▇/▇▇▇▇▇/▇▇▇▇▇.▇▇▇ or contact the Arizona Immunization Program Office at (▇▇▇)▇▇▇-▇▇▇▇. One of these items must accompany the EIIR card at all times: Copy of current official documented immunization record attached Religious Beliefs exemption form signed by parent/guardian attached Medical Exemption form signed by physician and parent/guardian attached Signed Laboratory Proof of Immunity form attached Notification of immunizations needed sent to Parent(s) or Guardian(s): mo /day/ yr mo /day/ yr mo /day /yr Updated immunizations received and attached: mo /day/ yr mo /day/ yr mo /day /yr Is child allergic to food or other substances? No Yes Is child usually susceptible to infections and if so, what precautions need to be taken? No Yes If yes, list precautions: Is child subject to convulsions and what should be our procedure if one occurs? No Yes If yes, specify procedure: Is there any physical condition that we should be aware of and what precautions should be taken (heart trouble, foot problem, hearing impairment, hernia, etc.)? No Yes If yes, list precautions: Additional comments: Other special instructions: This Emergency Information and Immunization Record Card is accurate and complete, front and back, and was provided by: G:\Forms\Emergency Information and Immunization Record Card (6/16) Select from list Student Name School Name Date of Birth Grade Has your child ever had chickenpox? (please circle one answer) Yes (go to #1) No (go to #2) Don’t Recall (go to #1)
Immunization Information. Students must have a minimum number of immunizations: 5 DPT, 2 Measles/Mumps/Rubella (MMR), 4 Polio, 3 Hepatitis B, 2 Varicella, and 2 Hepatitis A if date of birth is after 09/01/2005. This is state law.
Immunization Information b. The DEPARTMENT shall consult with the MCO, through a workgroup comprised of DEPARTMENT and MCO representatives that meets on a periodic basis, or a similar process, on the necessary data, methods of collecting the data and the format and media for new reports or changes to existing reports.
c. The DEPARTMENT shall provide the MCO with final specifications for submitting all reports no less than ninety (90) days before the reports are due. The MCO shall submit reports on a schedule to be determined by the DEPARTMENT, but not more frequently than quarterly. Before the beginning of each calendar year, the DEPARTMENT shall provide the MCO with a schedule of utilization reports which shall be due that calendar year. Due dates for the reports shall be at the discretion of the DEPARTMENT, but not earlier than ninety (90) days after the end of the period that they cover.
d. For each report the DEPARTMENT shall consider using any HEDIS standards promulgated by the NCQA which cover the same or similar subject matter. The DEPARTMENT reserves the right to modify HEDIS standards, or not use them at all, if in the DEPARTMENT's judgment, the objectives of the HUSKY A program can be better served by using other methods.
Immunization Information. For campers who reside within the United States, a United States Territory, or the District of Columbia:
Immunization Information. The DEPARTMENT shall consult with the MCO, through a workgroup comprised of DEPARTMENT and MCO representatives that meets on a periodic basis, or a similar process, on the necessary data, methods of collecting the data and the format and media for new reports or changes to existing reports.