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Wisconsin care immunization record 2026

The document is a Child Care Immunization Record form from the Wisconsin Department of Health Services, which outlines the legal requirements for immunizations for children entering child care centers. It details the necessary immunizations by age group, provides instructions for completing the form, and explains the waiver process for health, religious, or personal reasons. Parents or guardians must submit this form within 30 days of admission to ensure compliance with state law.

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Click ‘Get Form’ to open the Wisconsin Care Immunization Record in the editor.
Begin by filling out the Personal Data section. Enter your child's name, date of birth, and the name of the parent or guardian. Ensure all information is printed clearly.
Next, move to the Immunization History section. For each vaccine listed, input the month, day, and year your child received it. If you lack records, contact your healthcare provider for assistance.
In the Requirements section, review the minimum immunizations required based on your child's age. Make sure to check that all necessary doses are documented.
Proceed to Compliance Data and Waivers. Indicate if your child meets all requirements or if there are exemptions due to health, religious, or personal reasons.
Finally, sign and date the form in Step 5 to confirm its accuracy before submitting it back to the child care center.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (210 Votes)
2017	4.4 Satisfied (103 Votes)
2008	4.4 Satisfied (571 Votes)

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Can I get Wisconsin immunization records online?

Public Immunization Record Access This site offers the ability to view immunization records. You must provide a social security number or Medicaid ID to access the record. Click on the link below to begin searching for an immunization record or to read the Wisconsin Immunization Registry parent brochure.

Can I get a copy of my immunization records online in Wisconsin?

Go to the Wisconsin Immunization Registry (WIR) website. Once you are in WIR, look for the title Public Immunization Record Access. Inside the box underneath, click on the Public Immunization Record Access link. In the Immunzation Record Search screen, type in the first and last name and birth date of your child.

How do I get a copy of immunization records on MyChart?

Go to My Record Health Summary and select the Immunizations tab. You can see the immunizations youve received and the dates on which you received them. Click the immunization name to learn more. If your immunizations are not up to date, please docHub out to your clinic directly to have your information updated.

What can I do if I lost my immunization record?

If youve lost your immunization record, here are some steps you can take to obtain a replacement: Contact Your Healthcare Provider: docHub out to your doctor, pediatrician, or any healthcare facility where you received vaccinations. They often keep records of immunizations and can provide you with a copy.

What if I lost my Wisconsin immunization card?

1. How can I view and print my immunization record from the Wisconsin Immunization Registry? Clients may view their immunization record on the Wisconsin Immunization Registry website. Clients will be asked to provide their name, date of birth, and social security number.