Florida Form DH 680 Immunization: Grandparent and Caregiver Guide

What Form DH 680 Is and Why You Need It

Most children entering a Florida public school need a Florida Certification of Immunization — Form DH 680. A child with a valid exemption may use the applicable exemption instead, including Form DH 681 for a religious exemption. Under Fla. Stat. § 1003.22, a DH 680 or applicable exemption is required for standard enrollment, and it trips up kinship caregivers because the form isn't something you fill out yourself.

Form DH 680 is generated by a licensed healthcare provider through the Florida SHOTS immunization registry. The provider reviews or administers the child's vaccines, enters the records into the state database, and then prints or electronically submits the DH 680 to the school.

Can a Grandparent Consent to Immunizations?

Yes. Under Fla. Stat. § 743.0645, a grandparent is third on the statutory priority list for consenting to medical care for a minor. Ordinary immunizations are explicitly covered as "medical care and treatment" under § 743.0645(1)(b).

The requirement: you must make a reasonable attempt to reach the parent first. If the parent is unreachable and has not given contrary instructions, you can consent as the grandparent. The same applies to adult stepparents, adult siblings, and adult aunts or uncles — each in their place on the priority list.

You don't need a court order or a power of attorney to consent to immunizations. What you do need is to document the attempt to contact the parent (date, time, method) and be prepared to explain the situation to the provider.

Getting DH 680 Without Prior Records

If the child moved in suddenly and you have no immunization records:

1. Check Florida SHOTS first. If the child was vaccinated anywhere in Florida, their records may already be in the state registry. Any Florida healthcare provider can look this up.

2. Contact the child's previous provider. The old pediatrician or county health department can transfer records or fax a summary.

3. Start fresh if records are truly lost. The county health department can administer the required vaccines and generate a new DH 680. For younger children, this may mean restarting certain series, but the provider will determine the appropriate catch-up schedule based on the child's age.

County health departments provide immunizations at no charge or low cost. If the child has Medicaid, Florida KidCare, or qualifies for the Vaccines for Children (VFC) program, the vaccines are covered.

Form DH 3040: The School Entry Physical

Alongside DH 680, schools require Form DH 3040 — the School Entry Health Exam. This is a comprehensive physical performed by a licensed healthcare provider within 12 months before the child's first enrollment in a Florida school.

The exam includes a full physical assessment, vision screening, and hearing screening. Page 1 of the form requires a parent or caregiver signature authorizing the exam. As a relative caregiver consenting under § 743.0645, you can sign this page.

Both forms are available at county health departments, community health centers, and private pediatric offices. Scheduling both the physical and immunization visit in a single appointment saves time.

Religious Exemptions: A Different Rule

Form DH 681 (Certificate of Religious Exemption from immunization) follows a separate process entirely. A relative caregiver cannot independently sign a religious exemption form for a child. Under Florida law, the exemption must come from the child's natural parent or legal guardian, verified directly through the local County Health Department director or their authorized designee.

If a parent previously filed a religious exemption and you're continuing that decision, the county health department can confirm whether the DH 681 is on file.

The Timeline That Works

For caregivers enrolling a child in a Florida school:

1. Week 1: Call the county health department — request a Florida SHOTS lookup and schedule the DH 3040 physical and any needed immunizations
2. Week 1-2: Provider visit — physical exam, vaccines, DH 680 and DH 3040 generated
3. Week 2: Bring DH 680 (or DH 681, if applicable) + DH 3040 to the school along with your other enrollment documents

If the child qualifies under McKinney-Vento by lacking a fixed, regular, and adequate nighttime residence, including a doubled-up arrangement due to loss of housing, economic hardship, domestic violence, or a similar emergency, the school must enroll the child immediately and grant 30 days to get the health forms in order.

For a full walkthrough of the enrollment document stack — including district caregiver forms and front-desk scripts — the Florida School and Medical Consent Guide covers every step.

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