Submit the completed immunization form via email to immunize@dhec.sc.gov or fax it to (803) 898-3432. Alternatively, you can mail the form to the S.C. Department of Health and Environmental Control, 2600 Bull Street, Columbia, SC 29201. Ensure you retain a copy of the submitted form for your records. Verify that all required sections are completed accurately before submission to avoid delays and ensure compliance with the immunization requirements for childcare and school attendance.

Important dates for this form in 2024 and 2025 include the requirement effective date of July 1, 2023, and the expiry of certificates issued on June 30, 2022. Ensure all updates are completed before the beginning of the school year.

The purpose of this form is to ensure that all children attending childcare and school in South Carolina are properly immunized against preventable diseases. The South Carolina Department of Health and Environmental Control (DHEC) provides specific immunization requirements for different grade levels, along with guidelines for valid immunization certificates. This form helps maintain public health by verifying that children meet these immunization standards and receive age-appropriate vaccines. By adhering to these requirements, childcare facilities and schools can prevent the spread of vaccine-preventable diseases within their communities. The form also allows for specific exemptions, ensuring that children with medical or religious reasons are accommodated while still protecting the overall health of the population.

• 1. Child's Personal Information: Includes fields for the child's name, date of birth, and other identifying information.
• 2. Vaccination Records: Fields for documenting each vaccine dose the child has received, including the type of vaccine, date of administration, and healthcare provider details.
• 3. Medical Exemption: Section to be completed by a licensed physician for children with a permanent or temporary medical reason for exclusion from vaccines.
• 4. Religious Exemption: Section for parents or guardians to sign if immunizations conflict with their religious beliefs. Must be signed in the presence of a notary.
• 5. Special Exemption: Section for school-issued exemptions for children who have been unable to secure immunizations or documentation. Valid for 30 days.

Failing to submit this form can result in the child not being allowed to attend childcare or school. Legal actions and audits may ensue for non-compliance.

• Childcare Exclusion: Children without a valid immunization certificate or exemption will not be allowed to attend childcare facilities.
• School Exclusion: Students without a valid immunization certificate or exemption will not be allowed to attend school.
• Legal Actions: Failure to comply with immunization requirements may result in legal actions and audits by the Department of Health and Environmental Control.

• 1. Childcare Enrollment: Submit this form when enrolling a child in a childcare facility to ensure they meet immunization requirements.
• 2. School Enrollment: Submit this form when enrolling a child in a school to comply with state immunization laws.
• 3. Medical Exemption: Use this form to document a medical exemption from immunizations as provided by a licensed physician.
• 4. Religious Exemption: Use this form to document a religious exemption from immunizations as signed by a parent or guardian.
• 5. Special Exemption: Use this form to document a special exemption issued by the school for children unable to secure immunizations.