Montana schools use this one-page certificate to record a pre-K through 12th grade student's required vaccine dates and any medical or religious exemption. Whoever transcribes the official record signs that, to the best of their knowledge, the child received the listed doses, adding a printed name and facility name. Schools keep it on file as proof the student meets Montana's requirements.
A health care provider, school official or parent working from an official record enters the dates and signs. A medical exemption checked on the certificate must be backed by a medical exemption form on file.
Download the current version from the source each time; forms change without notice.
State of Montana School Certificate of Immunization
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.
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.
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No. The certificate notes that exemption status and related information do not populate from imMTrax. Vaccine dates can be transcribed from an official record, but a medical or religious exemption must be marked in the certificate's exemption section, with the matching exemption form kept on file at the school.
The certificate lists a Tdap booster as required before 7th grade entry. It also notes that Hib is required only for children 5 years and younger, while DTaP or Td, MMR, polio and varicella dates are recorded for all grades from pre-K through 12th.