Dec 3 2021 I hereby authorize the Illinois Department of Public Health to release the immunization records of the Patient identified above contained in ...
The Washington State Immunization Information System is a statewide lifetime immunization registry that keeps track of immunization records for people of all
Staff must record the required vaccine dose information and status of requirements for each pupil. See reverse side for guidance. CDPH 286 (10/23). Pupil Name (
Enter the dates for each vaccine your child has received to date. Specify the month day
o Must be verified with a health care provider signature. OR o Must have medical vaccination records attached so it can be verified for accuracy by school or
Notice: The Children and Hoosiers Immunization Registry Program keeps a record of immunizations that are entered into the Children and Hoosiers Immunization
A handwritten immunization record should be considered valid if it contains the vaccine name vaccination date (month
If you do not have an immunization record for this child contact your doctor or local public health department to obtain the records. TYPE OF VACCINE. First
'Record of Immunization' section of this form. This form may not be altered When immunization records have been lost or destroyed vaccination dates may be ...
Call your doctor or local health department and make a vaccine visit as early as possible. How do I complete the Student Immunization Record? Vaccines are one
Using The Vaccine Registry
To find you or your child’s vaccine records, you’ll need the person’s: 1. First and last names. 2. Date of birth. 3. Either Social Security number, Medicaid identification number, or health care member identification number. Step 1.Follow the links below to access the WIR public records portal in your preferred language: 1. English—Immunization Rec...
Just For Health Care Providers
We offer more details for health care providers and local health department workers. Learn more about WIR.