DH Form 680s

DH Form 680s

Florida SHOTS makes it easier than ever to provide DH 680 forms to your patients, parents, or caregivers.

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.
As of June 2, 2017, Florida SHOTS revised the creation process of the D.H. 680 form within the system to more efficiently comply with Florida’s statutes. An overview of those changes is available here, and answers to frequently asked questions about those changes are available here.


  • 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 680s

  • 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 healthcare 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!        Download Instructions