DD Form 3110 – Routine Immunization Screening Form: Pediatric

DDFORMS.ORG DD Form 3110 – Routine Immunization Screening Form: Pediatric – Immunizations are an important part of keeping children safe and healthy. It is crucial that healthcare providers stay up-to-date with the most current immunization guidelines in order to protect children from potentially dangerous diseases. To help healthcare providers keep track of a child’s immunization history, the Department of Defense created a form known as the DD Form 3110 – Routine Immunization Screening Form: Pediatric.

Download DD Form 3110 – Routine Immunization Screening Form: Pediatric

Form Number DD Form 3110
Form Title Routine Immunization Screening Form: Pediatric
Edition Date 3/11/2020
File Size 105 KB

What is a DD Form 3110?

DD Form 3110, also known as the Routine Immunization Screening Form: Pediatric, is an essential form used by healthcare professionals to help protect children from preventable illnesses. It serves as a comprehensive immunization record for children up to 18 years of age. The form is widely used by doctors and pediatricians to track the vaccinations that a child has already received and determine which ones are still needed.

Parents or guardians must fill out the DD Form 3110 before taking their child in for their routine immunization screening appointment. This includes providing relevant information regarding the child’s medical history, allergies or adverse reactions to past vaccinations, and any related medication use. Information provided on this form helps healthcare providers make sure that all recommended vaccines are administered safely according to standard practices and guidelines.

Where Can I Find a DD Form 3110?

The DD Form 3110 is an official document used for routine immunization screening. It is a form that must be completed by the parent or guardian of any child under the age of 18. The form can be found online and in most local healthcare offices.

This form is required to ensure that a child’s immunization records are kept up-to-date and to ensure that any new vaccines have been administered appropriately. This document also allows doctors and other medical personnel to make sure that a child’s vaccinations are current and up-to-date. Without it, they may not be able to properly diagnose or treat illnesses related to immunizations.

The DD Form 3110 provides valuable information about your child’s immunization history and helps you keep track of what vaccines they have received.

DD Form 3110 – Routine Immunization Screening Form: Pediatric

The DD Form 3110 is an important form for parents and guardians of young children. It is the routine immunization screening form used by healthcare providers to assess the immunization status of a child. This form can be filled out during a standard check-up or during any visit to a healthcare provider. It contains essential information that helps providers determine if additional vaccinations are needed.

The form asks parents or guardians to provide details about the type and date of each immunization received by their child, as well as any previous adverse reactions they may have had. This information is then used to assess the current state of protection against various infectious diseases and ensure that all necessary vaccines are administered when indicated. By completing this form, healthcare professionals can better protect their patients from illnesses that could be prevented through appropriate immunization coverage.

DD Form 3110 Example

DD Form 3110


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