Wisconsin Immunization Program
Childhood vaccine information and schedules
All external hyperlinks are provided for your
information and for the benefit of the general public. The Department of
Health Services does not testify to, sponsor, or endorse the accuracy of
the information provided on externally linked pages. Department of Health Services resources
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Day care - Immunization assessment booklet 2012-13 (PDF, 827 KB)
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Day care - Immunization record (PDF, 83 KB)
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Day care - Immunization record (Spanish) (PDF, 14.1 KB)
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Student - immunization record (English) (PDF, 46KB)
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Student - immunization record (Spanish)
(PDF, 52.0KB)
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Student - immunization record (Hmong)
(PDF, 52 KB)
- School report to Local Health Department (PDF, 21 KB)
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School report to the District Attorney (PDF, 10KB)
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Vaccine administration record (PDF, 14 KB)
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Vaccine administration record (Spanish)
(PDF,
15 KB)
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Required immunizations for school admission - Legal notice (English) (PDF, 60.2 KB)
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Required immunizations for school admission - Legal notice (Spanish) (PDF, 66.9 KB)
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Required immunizations for school admission - Legal notice (Hmong) (PDF, 37 KB)
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School requirements - Varicella, Tdap, and PCV (Pneumococcal)
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School based clinic consent - Tdap/Varicella (English) (PDF, 55 KB)
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School based clinic consent - Tdap/Varicella (Spanish) (PDF,
29 KB)
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School based clinic consent - Tdap/Varicella (Hmong) (PDF,
29 KB)
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School based clinic consent - Tdap only (English) (PDF,
27 KB)
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School based clinic consent - Tdap only (Spanish) (PDF,
27 KB)
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School based clinic consent - Tdap only (Hmong) (PDF, 27 KB)
Centers for Disease Control and Prevention (CDC)
American Medical Association (AMA)
Contacts
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Last Revised:
May 22, 2013
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