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Kentucky Certificate of Immunization Status (EPID 230)

Kentucky requires a Certificate of Immunization Status, EPID 230, on file for children in child care, preschool and public or private schools under 902 KAR 2:060. It lists vaccines and dates and certifies the child is current until a stated date, after which it is not valid. There is no separate medical exemption form: the certificate itself is marked medical exemption.

Who completes it

Physicians or APRNs licensed in any state, Kentucky-licensed PAs, pharmacists, local health departments and licensed facilities, and Kentucky Immunization Registry users issue it. An RN or LPN designee may sign; registry printouts need no signature.

Submitting and payment

How to submit it
Give it to the parent for the school or child care, where it is kept for inspection. Signed or registry-printed certificates may be faxed between medical offices, schools and child care facilities.

Good to know

  • A certificate marked 'medical exemption' must be issued for a child with a temporary or permanent medical contraindication to a vaccine.
  • Electronic copies from an EMR or the registry must match the official size, orientation and format and include the issuer's name, address and phone.
  • Provisional status certificates expire 14 days after the next dose is due for school, or 30 days for child care, and never last beyond one year.
  • Religious objections use the notarized EPID 230A, after which the provider issues a certificate marked 'religious objection.'

Get the official form

Download the current version from the source each time; forms change without notice.

Commonwealth of Kentucky Certificate of Immunization Status

Official page

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Where do I get blank Kentucky EPID 230 certificates?

Health care providers, pharmacists, local health departments and licensed facilities can obtain blank hard copies of EPID 230 and EPID 230A from the Cabinet for Health and Family Services. Electronic versions printed from an EMR or the Kentucky Immunization Registry are allowed if they match the official format.

How do I document a medical exemption in Kentucky?

Issue an EPID 230 marked 'medical exemption' for a child with a temporary or permanent medical contraindication to a vaccine. 902 KAR 2:060 does not use a separate medical exemption form, so the certificate itself carries the exemption, along with the vaccines given and the issuer's signature.

When must a Kentucky certificate be updated?

At child care enrollment, kindergarten, seventh and eleventh grade entry, school transfer, a legal name change, or a required school exam. If a certificate is no longer valid, an updated one is due within 30 days for child care or 14 days for school.