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  • Immunization Tracking Form - Maine.gov - State Me

Get Immunization Tracking Form - Maine.gov - State Me

IMMUNIZATION TRACKING FORM EXEMPT AND NON-IMMUNIZED STUDENTS Name of School School Year Student Name Grade All DTAP MMR Polio This list is to be maintained in School Health Office. Varicella.

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Your required immunizations include: Dose must be given on/after 16th birthday. Tdap (Tetanus, Diphtheria, Acellular Pertussis) One dose given within the past 10 years. Influenza (flu) required each fall when vaccine becomes available. Deadline will be set by your program.

The Maine Immunization Information System (ImmPact) is a statewide immunization information system that stores electronic immunization records. ImmPact combines the vaccines a person has received into a single record, even if they were given by different health care providers in the state.

Centers for Disease Control and Prevention.

Varicella (chicken pox); 5. Hepatitis B.; 6. Influenza; and 7. COVID-19.

The Universal Childhood Immunization Program is established to provide all children from birth until 19 years of age in the State with access to a uniform set of vaccines as determined and periodically updated by the Maine Vaccine Board.

Due to the high volume of requests, if you need a copy of your immunization record within the next 5 business days, please contact your health care provider. A parent or legal guardian can request records for children under the age of 18 years. Individuals over the age of 18 years old must request their own record.

Students, Employees, & Visitors: COVID-19 vaccinations and boosters are recommended as a way to prevent severe cases of COVID-19. Important: Participation in certain programs may require vaccination against COVID-19 due to requirements of third-party locations, such as student placement sites.

State of Maine Requirements Maine Law requires all degree-seeking students and full-time non-degree students born after December 31, 1956 to provide proof of immunization against TD (tetanus/ diphtheria) within the last 10 years and two doses of MMR (measles, mumps, rubella) after their first birthday.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232