Instructions For Completing The Alabama Certificate Of Immunization (Page 4 of 4) in pdf

Instructions For Completing The Alabama Certificate Of Immunization Page 4

INSTRUCTIONS FOR COMPLETING THE

ALABAMA CERTIFICATE OF IMMUNIZATION

RELIGIOUS EXEMPTION IMM-52

The Alabama Certificate of Religious Exemption from Immunization

(IMM-52) is to be used for individuals requesting exemption from all vaccines or from

selected vaccines. These forms are only issued by county health departments. If the

IMM-52 is to be used for exemption from select vaccines, enter the vaccine name(s) in the

spaces provided at the bottom of the form. An Alabama Certificate of Immunization (IMM-

50) should be created for vaccines administered. The expiration on the IMM-50 should

reflect the date of the next required dose of vaccine that is not listed as an exemption. If

the exemption is from all vaccines, mark the space provided at the bottom of the form

indicating all vaccines.

ALABAMA IMMUNIZATION REQUIREMENTS FOR CHILDREN

For Alabama Immunization Requirements for Children – click on the following link:

ALABAMA DEPARTMENT OF PUBLIC HEALTH – CERTIFICATE OF IMMUNIZATION

To place an order for Certificates of Immunization, please click on the following link:

CPM –Immunization

Revised October 2012

Instructions For Completing The Alabama Certificate Of Immunization Page 4