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 Guide​​to 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. ​

Contact Us

  • Please visit our contact us page located here.