Wisconsin Immunization Program
Resources - Links
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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.
Records and Reports
School and Daycare
- School Immunization Requirements Booklet 2011-12 (PDF, 456 KB)
- Day Care Immunization Assessment Booklet 2011-12 (PDF, 1 MB)
- Day Care Immunization Record (English) (PDF, 86.3 KB)
- Day Care Immunization Record (Spanish)
(PDF, 83.3 KB)
- Student Immunization Record (English) (PDF,
46.2 KB)
- Student Immunization Record (Spanish) (PDF,
51.8 KB)
- Student Immunization Record (Hmong) (PDF,
15.2 KB)
- School Report to Local
Health Department (PDF, 46.2 KB)
- School Based Clinic Consent (Tdap/Varicella) (PDF, 55.2 KB)
- School Based Clinic Consent (Tdap only) (PDF, 26.5 KB)
- School Report to the
District Attorney (PDF, 9.5 KB)
- Required Immunizations for School Admission - Legal Notice (English) (PDF,
60.2 KB)
- Required Immunizations for School Admission - Legal Notice (Spanish) (PDF,
66.9 KB)
- Required Immunizations for School Admission - Legal Notice (Hmong) (PDF,
37 KB)
Additional Resources
Links
Centers for Disease Control and Prevention
(CDC) Links
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Last Revised: January 27, 2012
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