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. Refer to this
Quick Reference Guideto get started.
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. Opted out patients/clients' ImmuNet information are not viewable to ImmuNet authorized users and not accessible through MyIR Mobile.
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
-
ImmuNet Enrollment Form -
Authorized users can enroll to access ImmuNet. Hard copies (here) can be downloaded for printing and distribution. Authorized users who have been granted access will be asked to read and agree to the ImmuNet Confidentiality and User Agreement
(copy here) when they sign in to ImmuNet.
For EHR-EMR Vendors
Note: Completing forms online is preferred, however, If you must complete a hard copy of any form, please email it using a secure email service if your form contains any PHI/PII to prevent exposing any sensitive information. You can contact ImmuNet Support to send you a secure email to submit your hard copy form.
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