ImmuNet Forms
ImmuNet is Maryland’s Immunization Information System (IIS) - a secure, web-based registry managed by the Center for Immunization at the Maryland Department of Health (MDH). Access to ImmuNet is restricted to authorized users and all information is confidential.
Forms for the Public
Request a copy of your or your child(ren)'s official vaccination records. Requests are processed as quickly as possible.
Use this form if you do not want your or your child(ren)’s vaccination records shared with healthcare providers in ImmuNet. Need a printable version? Download a hard copy here.
Submit this form if you previously opted out but now wish to allow healthcare providers access to your or your child(ren)’s vaccination records. Printable version available here.
Forms for Authorized Provider Users
Enroll as an authorized provider user to access ImmuNet. A printable version is available here.
All users must agree to the ImmuNet Confidentiality and User Agreement upon signing in.
For authorized providers requesting access to vaccination records of their patients who have opted out of ImmuNet.
Form for EHR-EMR Vendors
Each EHR-EMR vendor should complete this form to streamline the onboarding process.
Important Submission Information
- Online forms are preferred for faster processing and security.
- If you must submit a hard copy form containing Protected Health Information (PHI) or Personally Identifiable Information (PII), please use a secure email service to protect sensitive data.
- Need help submitting securely? Contact ImmuNet Support to request a secure email.
Contact Us
Need assistance? Visit our Contact Us page for support.
