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Edit Entry Screen

With the Edit screen, you can edit information that was previously recorded. You may change any of the information for a record. The input fields for Immunizations are described below. Some of these fields are required and some are optional. The required fields are indicated by an asterisk symbol (*). You must click the Save button for your changes to be recorded. After you click "Save" or "Cancel" you will be taken back to the Summary screen. The "Reset" button will return the fields to the original values before any changes were made. You may also choose to delete the entry by clicking the "Delete" button. If for some reason the system is not able to process your entry, the page will refresh with a message explaining what must be done to proceed.

Using this Page

Immunization (Required) - Select the immunization or vaccine from the drop-down list. If the specific name is not shown, select "Other" from the list and type the name into the following field.

Other - You may type the name of your immunization in this field if it does not appear in the drop-down list above. This field is disabled by default. To enable this field select "Other" in the list above. You may enter up to 100 characters.

Date (Required) - You must enter a date to identify a record. Select a date by clicking on the calendar icon. The calendar icon will open a pop-up window with a clickable calendar. By clicking a date in the calendar, the date field will be automatically set and you may continue filling out the form.

Method - Select the method in which the immunization was administered from the drop-down list (Injection, Inhalant, or By Mouth).

Reaction - If you experienced a reaction from the immunization, you may record it here. Several common reactions have been listed with checkboxes. You may check the boxes next to all that apply. A drop-down list is also provided with a more extensive selection of reactions. In addition to the checkbox items, you may select one reaction from this list.

Comments - This is where you can enter any additional thoughts you had about this particular immunization record. You may enter up to 255 characters.

Save - You must click this button to save the entry.