Az immunization record 2026

1. Click ‘Get Form’ to open the az immunization record in the editor.
2. Begin by filling in the 'Requestor’s Information' section. Enter your name, relationship to the minor (if applicable), current address, phone number, and email.
3. In the 'Immunization Record Requested For' section, provide the first name, middle name, last name, date of birth, and gender of the individual whose records you are requesting.
4. Specify what immunization records you are requesting by selecting from options such as 'Any/All immunizations', 'Childhood vaccinations', or 'COVID-19 Only'.
5. If requesting COVID-19 records, fill in the estimated dates and locations of vaccinations.
6. Review all entered information for accuracy before proceeding to sign and date the form.
7. Once completed, print the form and send it along with identification documents via email, fax, or mail as instructed.

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