ImmuNet Forms

ImmuNet is Maryland’s Immunization Information System (IIS). It is a secure web-based registry operated by the Center for Immunization at the Maryland Department of Health (MDH). ImmuNet information is confidential and available only to authorized users.

For Public 

  • Vaccination Records Request - Get your or your child(ren)'s vaccination records securely by registering at MyIR. Refer to this Quick Reference Guide​​​ to get started.​

  • Opt-Out Form - Use this form if you do not wish to share your or your child(ren)’s vaccination records with providers in ImmuNet. Hard copies (here​) can be downloaded for printing and distribution. 

  • Rescind Opt-Out Form - Submit this form if you change your mind and wish to allow your or your child(ren)’s vaccination records made available to your or your child’s provider(s).​ Hard copies (here) can be downloaded for printing and distribution.​

For Providers and Other Authorized Users

  • ImmuNet Enrollment Form - Authorized users can enroll to access ImmuNet. Hard copies (here) can be downloaded for printing and distribution.  Authorized users who have been granted access will be asked to read and agree to the ImmuNet Confidentiality and User Agreement (copy here​) when they sign in to ImmuNet.

For EHR-EMR Vendors

Note: If you complete a hard copy of any form, please mail or fax the completed form. Do not email the completed form as it places you at risk for exposing your sensitive information. Emailed forms will not be accepted unless you are able to use a secure email service.

Contact Us

  • Please visit our contact us page located here.