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Childhood Immunizations

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Attention parents and guardians: Please bring your child's most recently updated immunization record and the parent's government issued ID with a recognizable photo, date of birth, and signature.

Please complete the following form, before arriving at the clinic.

Need a copy of your child's shot record for school? Now you can download and print a PDF version for use at schools and child care centers. To learn how we have put together this handy guide: Parents 680 Form Retrieval Guide (PDF 356kb). Follow the instructions in the guide to download your child's shot record.

Resource List of Children's Medical Providers (PDF 21kb)

Recommended Childhood Immunizations
Age Vaccines Required
Birth Hepatitis B
2 months Roatvirus (RV), Diptheria -Tetanus - Pertusis (DTaP), Haemophilus influenzae type B (Hib), Pneumococcal Conjugate (PCV), Inactivated Polovirus (IPV)
4 months DTaP, Hib, IPV, PCV, RV
6 months DTaP, Hep B, Hib, IPV, PCV, RV, Influenza
12 - 15 months Measles - Mumps - Rubella (MMR), PCV, RV
12-18 months DTaP
4 - 5 years DTap, IPV, MMR, Varicella (Chicken Pox)
11 - 18 years Human Papillomavirus (HPV) - 3 doses for females, Meningococcal Conjugate (MCV), Tetanus, Diptheria, Pertusis (Tdap)

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