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Example of Immunization Record

Download this printable Immunization Record to keep a detailed log of your or your child's Immunizations and Vaccinations. Using this Immunization Record, you can easily keep track of which vaccines you or your child still need, the administering doctor or nurse, and if they had any adverse reactions to the vaccine. This Immunization Record lists most standard (current) vaccines that are recommended for adults and children.

We have also provided links for Immunization Forms, an Immunization Checklist and sample Health Services record that can be used in combination with our Example Immunization Record.



Immunization Record Example
Excel Version of Immunization Record Example




Examples of Immunization Record Templates:

Immunization Form
Health Professions Immunization Checklist
Immunization Medical Record

Examples of Immunization Record:

Immunization Form
Health Professions Immunization Checklist
Immunization Medical Record
Printable Vaccination Record forms
H1N1 Influenza Immunization Reporting Form
Immunization Consent Form