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Bureau of Immunization: Immunizations Across the Lifespan
A.G. Holley State Hospital Epidemiology STD Tuberculosis & Refugee Health

Immunization Forms

Unless otherwise noted, all documents below are Adobe PDF files under 1.25 MB and open in new window.

H1N1 Waste Form

Novel H1N1 Influenza Vaccine Waste Form

Department of Health Form DH 680 Manual - Opens in new window

SAMPLE DH 680
Florida Certification of Immunization

Manual

5740-000-0680-6
200/PK

Department of Health Form  DH 680 Computer - Opens in new window

SAMPLE DH 680
Florida Certification of Immunization

Computer

5740-099-0680-0
200/PK

Department of Health Form DH-681 - Opens in new window

SAMPLE DH 681
Religious Exemption from Immunization

5740-000-0681-4
200/PK

Department of Health Form DH 686 - Opens in new window

DH 686 Immunization Record

5740-000-0686-5
200/PK