Home
Forms Library
Request for Immunization Records form

Request for Immunization Records form 2025

Request for Immunization Records form Preview on Page 1

Show details

4.3 out of 5

39 votes

The document outlines the process for requesting immunization records from the North Dakota Immunization Information System (NDIIS). It details the system's purpose, which is to maintain confidential vaccination data for residents, and provides instructions for submitting requests, including required documentation and identification. The document emphasizes that requests must be accompanied by a valid ID and specifies conditions for requesting records for minors or adults. It also includes contact information for the North Dakota Department of Health and notes processing times.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to change Request for Immunization Records form online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making changes to your documentation takes just a few simple clicks. Follow these fast steps to change the PDF Request for Immunization Records form online for free:

Register and log in to your account. Log in to the editor with your credentials or click on Create free account to test the tool’s features.
Add the Request for Immunization Records form for editing. Click on the New Document option above, then drag and drop the document to the upload area, import it from the cloud, or using a link.
Change your document. Make any changes required: insert text and images to your Request for Immunization Records form, highlight important details, remove sections of content and replace them with new ones, and add symbols, checkmarks, and areas for filling out.
Finish redacting the form. Save the modified document on your device, export it to the cloud, print it right from the editor, or share it with all the parties involved.

Our editor is very user-friendly and effective. Try it now!

See more Request for Immunization Records form versions

We've got more versions of the Request for Immunization Records form form. Select the right Request for Immunization Records form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (39 Votes)
2017	4.3 Satisfied (39 Votes)
2014	4 Satisfied (43 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

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 do I get my immunization records in Nebraska?

Doctors and health clinics keep records of the vaccines they give to your child. Keep in mind that they may save records for only a few years.

Do doctors keep immunization records?

Yes, you can use the VA Blue Button, to view, print or download a combined list of your Immunization information, to include: VA Immunizations from your VA health record.

How can I get my old immunization records?

In the event that an immunization record would be come lost or destroyed, there a few ways to retrieve a replacement. Contact your primary care provider. Contact the facility where the immunizations were given. Accessing the Nebraska State Immunization Information System (NESIIS).

Can you get immunization records from Mychart?

Every state in the U.S., and some large cities, have their own IIS. All states collect data on child vaccinations to put into the IIS (though the cut-off age varies by state) and most states now also record adult immunizations in their IIS.