Immunization Record Form for Students

Children need vaccinations as soon as they come into this world, as their immune system is not so developed at that time and they are likely to catch any diseases. As they grow older and start attending school, the spread of disease from one child to another becomes easier and quicker.

So, schools get information about the shots that the parents of kids have given them to protect them from the disease throughout their lives.

The majority of educational institutes these days use the immunization record form that they require their students to fill out so that they can get immunization information. Schools can use this form at any time, but they often make sure that they get it filed within 30 days after the admission of a child to the school.

What is an immunization record form?

This is a form that keeps a record of the vaccines that have been administered to a child in his life. The purpose of keeping this form in records is to make sure that the school is keeping track of the well-being and health of every individual and that it cares for the safety of every individual.

Children usually require vaccines for various diseases as they have a slightly weak immune system and are usually more vulnerable than adults. Due to this, those kids who have not gotten vaccinated are likely to fall ill more frequently, and this also has a strong impact on their overall performance in studies and several other curricular activities.

What are the details to be included in the immunization record form?

When you are going to fill out this form, you should know what information you can expect that the form might ask you to provide. Here are a few very basic details that can be seen in this form:

Information about the student:

One form belongs to one student, and it contains information about only that individual. So, when the school has to see to whom the particular belongs, it will read the first part of it, which is about the individual who is enrolled as a student. The information to be provided includes the name, gender, date of birth, student ID, roll number, grade number, etc. These details make it easy for an institute to reach the student.

History of immunization:

This part of the form requires the child or his parents to provide information on the history of the vaccines that have been administered to the child in the park. This section has various fields and columns and they collect information including the date of the vaccination, disease, name of the vaccine, information about the doses, etc.

This enables the school to know if the child has gotten enough vaccines, as it has become a basic law across the world that every child should receive immunization against diseases like polio, measles, hepatitis A, B, C, mumps, and many other diseases.

Reasons for getting the specific shot:

If a child has not gotten the vaccine against a particular disease, parents will have to provide the reason for it. The reason should be logical and make sense. Some schools also administer the vaccines to students who are missing. However, it depends on their medical records that a school also collects from another source.

Consent clause:

Every school adds a clause in the form regarding the consent they take from the parents to keep the data regarding their child safe in the school’s database. Parents also agree that the information they have provided is correct and that no false or misleading information has been provided.


The person who fills out the form has to confirm his authenticity. For this purpose, he needs to sign the form at the end along with the date.

Template for the immunization record form:

Collecting the record is a basic process, and the school does not need to get into trouble for this very basic process. Therefore, a template has been created that can be used without facing any inconvenience. This template provides a ready-to-use form after the required level of customization.

Immunization Record Form for Students

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