Please contact your healthcare provider who provided your vaccination. Medical providers in Ohio are not required to report immunizations to the State Immunization Registry. It is possible that if Public Health- Dayton & Montgomery County did not administer all of the vaccines you have received, your record may not be complete. Copies of immunization/vaccine records may also be received by email, or fax.You will be called when it is ready to be picked up. They must be picked up by the record requestor with proof of ID. If you choose to pick the records up in person.Please allow a minimum of 7-10 business days for copies to be prepared.There is no charge for patients or parents to receive copies of their medical records.Public Health – Dayton & Montgomery County Please note that the form MUST have a signature from a parent, guardian or patient 18 years of age or older. You may return the form by mail, email, or fax.There MUST be a valid phone number on the request form or it cannot be processed.To obtain a record for someone you are a guardian of, either child or adult, you must provide a copy of: Custody paperwork, legal guardian paperwork or healthcare power of attorney.IIS State/Territory/City Registry Staff - Main & Technical Contacts. Contact information for registries in other states. You must also provide identification for yourself, by providing a copy of one of the following: Driver’s License, State Identification Card, U.S. This list matches the vaccine name or codes in Arizona State Immunization Information System (ASIIS) with the brand name or other common names of the vaccines you use most often. To obtain a record for a minor you must provide proof of your status as a parent or guardian with one of the following: Birth Certificate, Legal Guardian Paperwork, Custody Paperwork or most recent Tax Return showing the child listed as a dependent.To obtain a record for yourself, one of the following must be provided: Current Driver’s License, State Identification Card, U.S.See list below for acceptable forms of documentation. You must include a copy of all necessary supporting documentation with your request or it cannot be processed.Immunization Vaccine Record Release Request To obtain Immunization/Vaccination records from Public Health – Dayton & Montgomery County please follow the following steps (COVID-19 documentation requires a different process – click here for that ) Community Health Improvement Plan (CHIP).All Programs & Services at Public Health.
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