Immunization Record Information Request Form

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This form is intended for individuals that are having difficulty accessing their own or their children's immunization records through the myColorado mobile app or the Colorado Immunization Information System (CIIS) Public Portal.

Form responses are submitted to the Colorado Immunization Information System (CIIS) Help Desk. The CIIS Help Desk will follow up to your request via a secure email message sent to the email address you provide in this form.

Please only submit one form. Submitting multiple forms will result in an increased delay in receiving a response.

About the myColorado Mobile App (myVaccine Record)

Patients and parents/guardians of minors under 18 can now use the Colorado Immunization Information System (CIIS) Public Portal to view and print an official record of their immunizations: https://vaccines.colorado.gov

Note: Immunization records printed from the CIIS Public Portal may not be complete. The records include what has been reported to and entered into CIIS.

How to Use the Public Portal to Retrieve Your Immunization Records: https://drive.google.com/file/d/1H5ZPm-5sYVv_Iym0E_eWjd0ZajF2p-_e/view?usp=sharing

About the CIIS Public Portal *

I am attempting to access my own vaccination record via the myColorado mobile app

I am attempting to access my own vaccination record via the CIIS Public Portal

I am a parent or guardian attempting to access my minor child's vaccination record through the CIIS Public Portal

Other:

Required

What is the purpose of this request?

We didn't find an exact match

More than one immunization record was found

Other:

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