Choosing Which Part of the D.H. 680 Form to Use
When creating a D.H. 680 form, you must first choose the correct part of the form to use for each patient.
Remember:
- Part A (K-6th) Code 1
Select this option for children with the required immunizations, entering kindergarten through 6th grade. - Part A (7-12th Grade) Code 8
Select this for children with the required immunizations, entering 7th through 12th grade. Florida SHOTS will verify that the child also meets the requirements for a Code 1 before generating a certified Code 8. - Part B
Select this for children who are up-to-date, but still require one or more immunizations to attend school or daycare. This is a temporary medical exemption and needs an expiration date. - Part C (Permanent Medical Exemption)
This is for children who are technically up-to-date, but because they have a permanent medical reason for not receiving one or more specific vaccines. Part C may be issued in conjunction with Part A or Part B. Both Part A and C, or B and C, would be selected if you have a patient with a permanent medical exemption. Rarely, children may have a permanent medical exemption to all vaccines, and in this case, only a Part C is issued.
Electronic DH Form 680
- Schools and day care centers accept Florida SHOTS’ electronically certified DH Form 680s (authorized by administrative rule 64D-3.046 F.A.C.).
- Patients can now log on to our secure server directly and print electronically certified copies of DH Form 680 from their home computers, if their health care provider is a participating physician and provides them with the State IMM Id and Certification PIN of their child's DH Form 680.
- Electronically certified shot records are available for quick access with a Florida SHOTS-issued ID and pin number.