Request an Immunization Record

Medical records are kept on file in the Health Center and are held in confidence. Medical records are retained for seven years, after which they are destroyed. 

*Senior Reminder*

Don′t forget to request a copy of your Immunization Record before you graduate! You never know when you may need it and it′s always good to keep a copy for your personal records.

How Do I Request a Copy of My Immunization Record?

  • Fill out this Medical Release form (electronic/typed signature not accepted)
  • Email it:
  • This form may also be requested in-person at the Moore Moore Wellness Center.