Before a child may attend a school or child care center, a parent must provide proof of immunization status using the following types of documentation:
(1) A department-approved CIS form which must be signed by the parent. The CIS form must include:
(a) Name of child or student;
(b) Birth date;
(c) Type of vaccine(s) administered;
(d) Month, day, and year of each dose of vaccine received;
(e) A section to indicate whether an accompanying COE form has been provided;
(f) A section to document serologic proof of immunity which must be signed by a licensed health provider and include a copy of a lab report; and
(g) Parent signature and date.
(2) A department-approved COE form signed by a parent. A COE form must include:
(a) Name of child or student;
(b) Birth date;
(c) A section to indicate a medical exemption for one or more vaccines which must be signed by a licensed health care provider;
(d) A section to indicate a religious exemption for one or more vaccines;
(e) A section to indicate a personal or philosophical exemption for one or more vaccines;
(f) Notice to parents that if an outbreak of vaccine-preventable disease for which the child is exempted occurs, the child may be excluded from the school or child care center for the duration of the outbreak; and
(g) Parent signature and date.
[Statutory Authority: RCW 28A.210.140. 09-02-003, § 246-105-050, filed 12/26/08, effective 1/26/09.]