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Iowa immunization form 2025

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The document is a Certificate of Immunization from the Iowa Department of Public Health, certifying that an applicant has received age-appropriate vaccinations required for licensed child care or school enrollment. It outlines the necessary vaccines, their administration schedule, and requirements based on the applicant's age. The certificate must be signed by a qualified medical professional and may be reviewed by health authorities.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (66 Votes)
2012	4 Satisfied (40 Votes)
2006	4.3 Satisfied (79 Votes)

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How do I get my immunization records in Iowa?

To obtain a copy of your immunization or health screening record, or your childs record, please complete the request form, provide a copy of your state-issued ID (such as Drivers License). Email the form to the IRIS Program irisenrollment@idph.iowa.gov. Please allow 3 - 5 working days to process record requests.

What is the Iowa immunization Code?

Iowa Immunization Requirements Iowa Code, Chapter 139a. 8(6) and Iowa Administrative Code, 641-7.7(139) outline the immunization requirement for students attending licensed child care centers and elementary or secondary schools.

How do I get my immunization form signed?

Ask your doctor, pharmacist or other vaccine provider for an immunization record form or download and use this form [4 pages]. Bring this record with you to health visits, and ask your vaccine provider to sign and date the form for each vaccine you receive.

What is a religious immunization exemption certificate?

A religious exemption is a formal request submitted by someone subject to a vaccination requirement to be excused from that requirement.

What is the code 139a 8 in Iowa?

2. a. A person shall not be enrolled in any licensed child care center or elementary or secondary school in Iowa without evidence of adequate immunizations against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, rubella, and varicella.

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What is the immunization billing code?

90460: Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered.