Immunization Home

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Influenza
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   - Seasonal

Disease Information
   - Measles
   - Mumps  
   - Pertussis
   - Rubella
   - Varicella

Childhood Vaccine Information

Adult Vaccine Information 

Requirements

Wisconsin Immunization  Registry (WIR)

Vaccines for Children Program

Resources/
Links

Vaccine Safety

Local Immunization Coalitions

Wisconsin Immunization Program

Resources - Links

All external hyperlinks are provided for your information and for the benefit of the general public. The Department of Health and Family Services does not testify to, sponsor, or endorse the accuracy of the information provided on externally linked pages.

Records and Reports

• Vaccine Administration Record (PDF, 14.3 KB)
• Vaccine Administration Record (Spanish) (PDF, 14.5 KB)
• Pertussis Case Report (DPH 4236) (PDF, 95.3 KB)
• Vaccine Temperature Log - Celcius (DPH 42023) (PDF, 302 KB)
• Vaccine Temperature Log - Fahrenheit (DPH 42024) (PDF, 303 KB)

School and Daycare

• Day Care Immunization Record (DPH 4192)
  English (PDF, 20.1 KB)
• Student Immunization Record (DPH 4020L)
  English - Spanish (PDF, 46.2 KB)
• School Based Clinic Consent Forms Tdap and Varicella (PDF, 55.2 KB) - Tdap only (PDF, 26.5 KB)
• School Report to the District Attorney (DPH 4212) (PDF, 9.5 KB)
• Legal Notice - Required Immunizations for
  Admission to Wisconsin Schools (DPH 4001)
  English - Spanish - Hmong (PDF, 37 KB)

Additional Resources

• College Students and Meningococcal Disease
• Communicable Disease Fact Sheets
• Regional Immunization Program Advisors
• Selected Vaccine Preventable Diseases Reported from 1976- 2003 (PDF, 15 KB)
• Wisconsin Local Public Health Departments
• Wisconsin Council on Immunization Practices
• Yellow Fever
• 2007 Immunization Program Spring Seminar (PDF, 273 KB)

Links

• Immunization Action Coalition
• The Immunization Gateway
• National Network for Immunization Information
• Publications-IAC
• American Medical Association- Coding Guidelines for Vaccine Preventable Hepatitis (VPH) (PDF, 62 KB)

Centers for Disease Control and Prevention (CDC) Links

• CDC Flu Gallery
• National Immunization Program - CDC
• CDC en Español - Inmunización
• NIP News- Current Vaccine Delays and Shortages
• Vaccine Management: Recommendation of Handling and Storage of Selected Biologicals
• Adult Immunizations
• Assessment, Feedback, Incentives, Exchange (AFIX)
• Immunization Educational and Training Materials
• American Indian and Alaskan Native Materials
• In the Spotlight for Health Care Professionals
• Health Marketing
• Community Preventive Services

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Last Revised: April 22, 2008