Forms
This is the form to be completed by parents or guardians indicating whether or not a child is to be vaccinated at school.
This form allows you to provide immunization information for entry into NMSIIS.
CDC-Revised document as COVID-19 Vaccine Program Provider Agreement
CDC-Supplemental document as COVID-19 Vaccine Redistribution Agreement
This form may be used by adult patients aged 19 and older to provide vaccination consent to a healthcare provider.
Got Shots Fillable Form
Got Shots? Fillable Form - Eng
Got Shots? Fillable Form - Esp
This form should be used as Consent for COVID-19 Vaccinations
This form should be used as Consent for COVID-19 Vaccinations
This form should be used as Consent for COVID-19 Vaccinations
This form should be used to report out of range temperature incidents and submit a troubleshooting record to the vaccines for children program.
Cibola, McKinley, San Juan, Sandoval, Torrance, and Valencia
Chaves, Curry, DeBaca, Lincoln, and Quay
Eddy, Lea, Lincoln, and Roosevelt
This is a customizable form for use by schools to collect consent from parents so students' historic immunization records may be added to NMSIIS.
This form is to be used for needles/syringes, and e-kit medications and is for Vaccines for Children Approved Sites Only.
This is the letter addressed to parents or legal guardians to determine whether or not a child is to be vaccinated at school. This letter is to be sent out with the VFC school immunization consent form.
VFC Middle School Vaccination Letter/Permission Form (Spanish)