Individuals
Request a Shot Record
A patient may request copies of their immunization record
by completing a Request to Release Immunization Record Form (accessed
in various languages through the links below), having it
notarized, and submitting it to the Colorado Immunization
Information System, along with a legible photocopy of their driver's
license or other secure and verifiable document.
Prior to completing the form, please call the CIIS Help Desk
at (303) 692-2437 or 1 (888) 611-9918 to confirm that the requested
record exists in the Colorado Immunization Information System.
Please note that CIIS is a voluntary system, and as such, does not
contain immunization records for ALL Coloradans.
Note: Incomplete forms, forms without proper ID, and forms
that are not notarized will not be accepted.
Request to
Release Immunization Record Form - English
Request to Release Immunization Record Form -
Spanish
Request to Release Immunization Record Form - Russian
Request to Release Immunization Record Form - Vietnamese
Please mail or deliver to:
Colorado Department of Public Health and Environment
Colorado Immunization Information System (DCEED-IMM-A3)
4300 Cherry Creek Drive South
Denver, CO 80246-1530
Fax to: 303-758-3640
Email to:
CDPHE-CIIS@dphe.state.co.us
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