Immunization Record Request
To request an immunization record for yourself or your child, fill out the Authorization to Release ImmTrac2 History form. Those who are 18 years or older must sign an IMMTrac2 Adult Consent Form (EF11-13366). To maintain immunization records in the registry, they must submit the form by their 26th birthday.
1. To request a copy of a vaccine record, download the Authorization to Release IMMTrac2 History form.
2. Complete the form.
3. Send completed form to DSHS Immunization Unit:
Texas Department of State Health Services
Immunization Unit - ImmTrac Group
MC 1946, PO Box 149347
Austin, TX 78714-9347