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 Utah Department of Health



Immunization Record Requests

To request your own immunization record, you must be of legal age (18 years or older). If you are requesting the record of a minor child (under age 18), you must be the child's parent or legal guardian at the time of the request.

You can request your immunization record in the following ways:

Option 1: Request a record from your local health department

All Utah local health departments use or are connected to Utah Statewide Immunization Information System (USIIS). Contact your local health department and ask them to print an Official USIIS Personal Utah Immunization Record for you.

Click here for a list of Local Health Departments.

Option 2: Request a record from your healthcare provider

Most healthcare providers in Utah use or are connected to the Utah Statewide Immunization Information System (USIIS). Contact your provider and ask if they can give you an Official USIIS Personal Utah Immunization Record. If your provider does not participate in USIIS they can print your immunization record from their own medical record system.

Option 3: Submit a request to USIIS

You can request your own or children's immunization record by submitting the USIIS Immunization Record Request form. This form must be filled out completely and notarized. You can submit your form using the information below:


Mail: Immunization / USIIS Program
P O Box 142012
Salt Lake City, UT 84114-2012

Email: immunize@utah.gov

Fax: (801) 538-9440

File: Immunization Record Release.pdf





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