Mississippi form 121 2025

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From a county health department: If you do not have a Mississippi health care provider for your child, contact a county health department near you to request a Form 121. Online: You can register with our MyIR service, which will try to locate your childs immunization records.
School Immunizations Diphtheria, Tetanus, Pertussis (DTaP) Polio (IPV) Hepatitis B. Measles, Mumps, Rubella (MMR) Chickenpox (Varicella)
MyIR: Get Immunization Records and Forms Online. MyIR provides easy, one-stop access to immunization records for you and your family. Immunization records and the Mississippi school immunization entry form (Form 121) used to require a trip to your doctor or a county health department.
Establishing Mississippi Residency Current MS Drivers License or State-issued ID (Persons moving into MS permanently have 60 days per state law to acquire drivers licenses.) Mortgage document matching address. Homestead exemption matching address.
Religious Exemption Policy To request a religious exemption from one or more required vaccinations for Mississippi school entry, the parent or guardian must complete the MSDH Religious Exemption Request (Form 139-R) and submit to the County Health Department (appointment is required: 855‑767‑0170).
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