PROCESSING

Request for State of Georgia Official Immunization Record

Instructions for completing this Request

Please use one of the following recommended browsers to complete this form: Chrome, Edge, Firefox, Safari

Proof of identity: All immunization record requests must be accompanied by document(s) that identify the person requesting the immunization record. Examples of acceptable forms of identification include: a state-issued photo driver’s license with address, a state-issued photo identification card with address, a U.S./Foreign passport or passport card with a photo, a school ID, or a Green Card, etc. Please ensure the copy of identification submitted is unexpired and legible. If the record requested is for a minor under 18 years of age, please state your relationship to the minor in the "Requestor’s Relationship" field.

Replacement COVID vaccination cards: The CDC has stopped printing COVID vaccination cards. If you need a replacement card, you may visit a public health department to obtain one while supplies last.

Processing time: Electronic Immunization Record Requests will typically be processed within 5-7 business days but may take up to 10 business days. If your request is urgent, please visit your county’s public health department or private provider for possible same day service.

Please note: This form is generally the quickest way to receive your records from our state office, however if you are unable to submit this form please contact our state office for additional assistance at (404) 657-3158.

Immunization Record requested for:

(Jr, Sr, III, etc.)
Gender

Requestor’s Information (Person requesting record)

(If person is under 18 years of age)
(Please attach a valid and current form of ID and / or any other supporting documents required)
(Maximum file size 5MB and only PDF,PNG, and JPG documents allowed)
Terms & Conditions
If requestor is a social services agency, healthcare facility, or non-biological parent, include supporting documentation such as: signed medical release; court orders; birth certificates; guardianship/custody; etc., as applicable. Registry information is confidential and will not be released to third parties without proper documentation.
E-Signature