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Certificate of Immunization - Iowa Department of Public Health - idph state ia 2025

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The document is a Certificate of Immunization from the Iowa Department of Public Health, which certifies that an applicant has received age-appropriate immunizations required for enrollment in licensed child care or school. It includes sections for personal information, vaccination records, and specific immunization requirements based on age groups. The document outlines the minimum vaccine doses needed for various age ranges and emphasizes compliance with state health regulations.

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How to use or fill out Certificate of Immunization - Iowa Department of Public Health - idph state ia

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Click ‘Get Form’ to open it in the editor.
Begin by entering the applicant's last name, first name, and middle name in the designated fields.
Fill in the date of birth and address, ensuring all information is accurate for proper identification.
Provide a contact phone number in the specified format to facilitate communication if needed.
In the certification section, ensure that a qualified individual (physician, nurse, etc.) signs and dates the form to validate immunization records.
Complete the vaccine section by listing each vaccine received along with the date given and source (doctor/clinic).
Review all entries for accuracy before saving or printing your completed certificate.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (66 Votes)
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2006	4.3 Satisfied (79 Votes)

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How do I get my immunization records from Iowa?

To get a copy of an immunization or health screening record for yourself or your child, complete the request form. You will need to also provide a copy of your state-issued ID (such as a drivers license). Email the form to the IRIS Program irisenrollment@idph.iowa.gov.

How can I find my old vaccination records?

Go to My Record Health Summary and select the Immunizations tab. You can see the immunizations youve received and the dates on which you received them. Click the immunization name to learn more. If your immunizations are not up to date, please docHub out to your clinic directly to have your information updated.

How to submit immunization records to Iowa state?

How to Submit Immunization Records. You may submit immunizations information through our patient portal. You will receive an email to your iastate.edu email address with a link to sign-up for the ISU Student Health Patient Portal. You must use the link embedded in the portal invitation email to activate your account.

What is a provisional immunization certificate?

Provisional enrollment may be granted when a child is transferring from another elementary or secondary school within the USA or has received one dose of each of the required minimum age-appropriate vaccines. The Provisional Certificate is valid for 60 days only and must have an expiration date.

What is the certificate of immunization exemption in Iowa?

The purpose of the Iowa Certificate of Immunization Exemption is to provide a formal process for individuals who have genuine religious beliefs conflicting with immunization mandates. This form ensures that those beliefs are documented legally and appropriately recognized in educational and childcare settings.

how to get your immunization records online

Iowa Immunization form Iowa Department of public health Immunization Program Can i get a copy of my immunization records online Iowa Iowa Immunization record request Iowa Immunization Exemption form Wisconsin Immunization records IDPH Immunization Requirements Public immunization record access

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Can I get a copy of my immunization records online in Iowa?

visits you made to local public health departments or neighborhood clinics. When physicians retire or a medical practice changes hands, old patient records may be sent to a medical record storage company. You may be able to obtain records directly from the company for a fee. baby books and school or camp forms.