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Child Care Immunization Form Requirements
Required proof of immunization for admission to child care facilities

The MDH regulations governing the licensure of child care facilities mandate that each child in a licensed facility have immunizations according to the recommended immunization schedule. All children must have one of the following forms before enrollment in a licensed child care facility.

  • Certificate of Immunization Compliance (Form 121). This form MUST be signed by the District Medical Director, a physician, nurse, or designee.
  • Certificate of Medical Exemption (Form 122). This form must be signed by the District Medical Director.
Chicken Pox (Varicella) Vaccinations

Effective August 2002, Varicella vaccination, or a history of the Chicken Pox Disease, is required for all children 12 months of age and older enrolled in a childcare or head start center.



 
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