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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.


  • 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.

Learn How to Issue Electronically Certified 680s.