Forms
Colfax, Guadalupe, Harding, Los Alamos, Mora, Rio Arriba, San Miguel, Santa Fe, Taos, and Union
Cibola, McKinley, San Juan, Sandoval, Torrance, and Valencia
Chaves, Curry, DeBaca, Lincoln, and Quay
Eddy, Lea, Lincoln, and Roosevelt
Catron, Dona Ana, Grant, Hidalgo, Luna, Otero, Sierra, and Socorro
Complete this log when transporting vaccines to an alternate or back-up refrigerator, or when transferring to another provider.
This form is used by a patient/parent/legal guardian to remove records from the New Mexico Statewide Immunization Information System.
Participant organization security and confidentiality agreement for the New Mexico Statewide Immunization Information System.
NMSIIS User Security and Confidentiality Agreement 2024
This form may be used by individuals requesting a religious or medical exemption to immunization for their children whom attend any public, private or parochial pre-school, kindergarten, elementary, secondary school, or home school and for children attending daycare of childcare facilities.
This form may be used by individuals requesting a religious or medical exemption to immunization for their children whom attend any public, private or parochial pre-school, kindergarten, elementary, secondary school, or home school and for children attending daycare of childcare facilities.
This form is used by a patient/parent/legal guardian to decline to participate in the New Mexico Statewide Immunization Information System.