UTAH SCHOOL IMMUNIZATION RECORD - Davis.K12.ut.us 2026

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The Utah School Immunization Record is a mandatory document for student enrollment in schools and early childhood programs, detailing required immunizations as per Utah law. It includes sections for student and parent information, vaccination history, and exemption procedures for medical, religious, or personal reasons. The record is part of the student's permanent school file and must be verified by health authorities.

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Click ‘Get Form’ to open the UTAH SCHOOL IMMUNIZATION RECORD in the editor.
Begin by entering the student’s name, gender, and date of birth in the designated fields. Ensure accuracy as this information is crucial for record-keeping.
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.
Record each vaccine received by the student by entering the month, day, and year in the appropriate boxes for each immunization listed. This includes DTaP, Polio, MMR, and others as specified.
Complete the 'SCHOOL AND EARLY CHILDHOOD PROGRAM USE ONLY' section by indicating whether all immunization requirements have been met or if conditional admission applies.
If applicable, check any exemptions granted for medical, religious, or personal reasons and ensure proper documentation is attached.
Finally, complete the authorized signature section with a date to finalize the form before submission.

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2018	4.8 Satisfied (65 Votes)
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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to print immunization records from docket?

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.

How do I get my childs immunization records in Utah?

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.

Does your school have your immunization records?

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.

What is the app for immunization records in Utah?

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.

How do I get my childs immunization records online at Utah?

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.

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How to obtain your childs immunization records?

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.