Wyoming Child and Family Development, Inc.
“A Non-Profit Public Service Organization”
Immunization Exclusion Notice
To the Parent(s) or Guardian(s) of __________________________________________
Wyoming Immunization Law states that all children attending preschool or childcare, who are older than 18 months of age, need to be properly immunized and show written proof of immunization from a doctor’s office or Public Health Office. Preschools and childcare facilities must exclude children from their programs after 30 days of enrolment, if the child is missing immunizations and/or written proof of immunizations.
Thirty days have passed since your child enrolled in our program and you have not provided written proof that your child has completed missing immunizations. Wyoming Child and Family Development (WCFD) is required by state law to exclude your child from attending group activities at our Early Childhood Education Center as of this DATE:
As stated in the Immunization Compliance Notice One, your child is missing the following immunizations (Circles indicate missing immunizations): DTaP Polio MMR Hib Hep-B 1st 1st 1st 1st 1st 2nd 2nd 2nd 2nd 3rd 3rd 3rd 3rd 4th 5th(Kindergarten)
4th(Kindergarten) 4th
2nd(Kindergarten)
Your child will be allowed to attend group activities at our Early Childhood Education Center as soon as he/she has received missing immunizations and you submitted written proof of these immunizations. Sincerely, Laurie Faber, RN, BSN Health Services Coordinator
To be completed by Center issuing notice
Name of Center
Phone Number
Center Coordinator Signature
Date
Center Nurse Signature
Date
NOTE: Make 3 copies of this notice – send one to the child’s teacher, one to the Health Services Coordinator and place the other copy in the Child File.
P\Forms\Immunization Exclusion Notice
08/08