UTAH SCHOOL IMMUNIZATION RECORD - Davis.K12.ut.us 2025

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  1. Click ‘Get Form’ to open the UTAH SCHOOL IMMUNIZATION RECORD in the editor.
  2. Begin by entering the student's name, gender, and date of birth in the designated fields. Ensure accuracy as this information is crucial for school records.
  3. Next, fill in the parent/guardian's name, mailing address, city, zip code, and telephone number. The parent/guardian must also provide their signature to validate the form.
  4. Record each vaccine received by entering the month, day, and year in the appropriate boxes for DTP, Hib, Polio, MMR, and other vaccines listed. Make sure to follow the specific instructions regarding doses.
  5. Complete the 'SCHOOL AND EARLY CHILDHOOD PROGRAM USE ONLY' section by indicating whether all immunization requirements have been met or if conditional admission applies.
  6. Finally, ensure that an authorized signature is provided along with the date to finalize the record. This can be done digitally through our platform for convenience.

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Select the standard share icon to text, email, or print a copy of your official immunization report(s). This button is represented as a box with an arrow that appears next to your name on the Immunization Records screen.
Option 1: Request a record from your healthcare provider Most healthcare providers in Utah use or are connected to the Utah Statewide Immunization Information System (USIIS). Contact your provider and ask if they can give you an Official USIIS Personal Utah Immunization Record.
Most schools keep vaccination records on file. Schools may keep records for a year or two after a student leaves or graduates. Contact your childs school for more information.
Docket makes it easier than ever for residents of AK, DC, ID, ME, MN, MO, NJ, ND, UT, and WY to access personal and family immunization records.
You can request your Utah immunization record in 4 ways: From your Healthcare Provider. Through the Docket mobile app. From the Utah Department of Healths Utah Statewide Immunization Information System (USIIS) From the Southeast Utah Health Department for Utah records only.

People also ask

You can request a copy from the school nurse or administration. State Immunization Registry: Many states have immunization registries where vaccination records are maintained. You can check with your states health department or visit their website for information on how to access these records.

utah school immunization record