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Immunization Records Request

  1. *COVID Vaccine* If you were vaccinated with Operation Safe or North Kansas City Hospital, a record of your vaccination can also be found in the myhealth patient portal. Learn more.

    To request a copy of an immunization record, please fill out the following information:

  2. How to Receive Record*
  3. Which records would you like?*
  4. Persons or facilities who can receive immunization records: Parent or Legal Guardian, Schools/Group Homes/Medical Facilities, Foster Parents, or Legal Guardian of an Incapacitated/Disabled Adult.

    A parent cannot request records for a child 18 and older.

  5. Leave This Blank:

  6. This field is not part of the form submission.