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2. DHHS is now offering immunization records translation services to residents looking to enroll their children in the school system. If you are interested in our immunization record translation services, please complete the Immunization Record Translation Request Form and we will contact you when the records are ready for pick up. Please have the following information ready:

   • Scanned version or picture of all immunization records that you need translated
   • Scanned version or picture of child's government-issued photo ID
   • Child's demographic information
   • Parent's contact information
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
16. Date of Birth*
    Date of Birth
17. Photo ID*
18. Vaccine Record*
20. Parent/Guardian First Name
21. Parent/Guardian Last Name
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field