41-02 · Immunization Records

The child care facility is responsible for obtaining for each child in care a current, complete and properly executed Florida Certification of Immunization form Part A-1, B, or C, DH 680, which is incorporated by reference in 65C-22.001(7)(o), F.A.C., or the Religious Exemption from Immunization form, DH 681, which is incorporated by reference in 65C-22.001(7)(p), F.A.C., from the custodial parent or legal guardian. DH Form 680 and DH Form 681 may be obtained from the local county health department. Specific immunization requirements are included and detailed in the most current edition of the Immunization Guidelines-Florida Schools, Child Care Facilities and Family Day Care Homes as promulgated by the Florida Department of Health. The facility is missing two immunization records for two children. Please email licensing office via email by 3/2/25