Immunization Record Request Form - Arizona Department of Health 2025

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Popular health topics. Heat Safety. Extreme Heat Preparedness. Vital Records (Birth/Death Certificates) Immunization. AZ Care Check (Licensed Facilities Info) COVID-19. Marijuana.
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.
Discover AZ Complete Health. We have changed our name! Health Net Access and Cenpatico Integrated Care are now Arizona Complete Health! At Arizona Complete Health we understand that nothing is more important than taking care of you and your family.
Death records can also be found on Ancestry: Arizona, County Coroner and Death Records, 1881 - 1971. Please note: If you are an Arizona resident, you can access the records from the Arizona State Archives that have been added to Ancestry for free. Click here to enter your zip code and view the collections on Ancestry.
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Step 1: Log into Health Portal. . Step 2: Select Medical Clearances on the left. Step 3: Enter Measles/M.M.R. Information. Step 4: Upload Immunization Record. Step 5: Allow 3 business days for review and processing.
Arizona State Immunization Information System (ASIIS) Overview. The Arizona State Immunization Information System (ASIIS) is an immunization registry designed to capture immunization data on individuals within the state.
ADHS is responsible for a number of programs including licensing and regulation of health care and childcare facilities; disease control; immunization education and promotion; emergency preparedness; emergency medical services; state laboratory; public health statistics; radiation regulatory programs; and vital records

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