ImmuNet Forms
ImmuNet is Maryland’s Immunization Information System (IIS). It is a secure web-based registry operated by the Center for Immunization at the Maryland Department of Health (MDH). ImmuNet information is confidential and available only to authorized users.
For Public
Vaccination Records Request - Get your or your child(ren)'s vaccination records securely by registering at MyIR. See this page for more information about MyIR.
-
Opt-Out Form - Use this form if you do not wish to share your or your child(ren)’s vaccination records with providers in ImmuNet. Hard copies (here) can be downloaded for printing and distribution.
-
Rescind Opt-Out Form - Submit this form if you change your mind and wish to allow your or your child(ren)’s vaccination records made available to your or your child’s provider(s). Hard copies (here) can be downloaded for printing and distribution.
For Providers and Other Authorized Users
For EHR-EMR Vendors
Note: If you complete a hard copy of any form, please mail or fax the completed form. Do not email the completed form as it places you at risk for exposing your sensitive information. Emailed forms will not be accepted unless you are able to use a secure email service.
Contact Us