Maryland Healthcare Personnel Immunization Initiative - PHPA - ideha dhmh maryland 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your personal information in the designated fields, including your name, birthdate, and chart number.
  3. Review the vaccination history section and fill in details for each vaccine received, including type, date given, and manufacturer.
  4. For any vaccines not received, check the appropriate reasons from the provided list or write in your own reason.
  5. Ensure you provide a signature and date at the bottom of the form to confirm your understanding of the information presented.
  6. Once completed, save your document and share it with relevant healthcare personnel as needed.

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Instructions for uploading immunizations: Step 1: Go to .myuhc.umd.edu Step 2: Enter your directory ID and password to log on, then enter your UID (University ID) in the box and hit ENTER Step 3: Click on Required Immunizations and Forms (on the left hand side of the page) Step 4: Carefully enter your immunization
Maryland State Law (COMAR 10.06. 04.03) requires all students enrolled in prekindergarten through Grade 12 to receive age-appropriate immunizations. The school must have proof of immunizations before allowing a student to begin school.
ImmuNet is Marylands confidential and secure Immunization Information System (IIS). It is a statewide computerized database that collects and maintains vaccination records for children and adults. Using an IIS like ImmuNet helps improve public health by: Supporting cost-effective and efficient disease prevention.
To do this, students will need to: Log in to the patient portal using their UGA ID and password. Click on the Immunizations tab. Upload their immunization records (in PDF or JPEG format) Complete the immunization questionnaire.
How to Contact Your Jurisdictions IIS contact the IIS in your state or in the state where you or your child received their last shots to see if they have records. contact your immunization provider directly or your local or state immunization program through your states health department.

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Required immunizations include two MMRs (measles, mumps, rubella) and completion of MSUs Tuberculosis Screening Form. Forms can be found at the Student Wellness website. Bozeman, MT 59717-3260. Immunizations records can also be faxed to (406) 994-2504 or emailed to immune@montana.edu.
Submit the George Mason Certificate of Immunization to the Immunization Office through the secure, online patient portal or by mail. Submission details are on the form. Students must complete student sections and a health care provider must complete the remaining sections of the Certificate of Immunization.

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