Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the document and open it in your chosen editor.
2. Begin by entering your full name in the specified field. This identifies you as the person completing the form.
3. Indicate your relationship to the patient by checking the appropriate box (self or parent/guardian).
4. Fill in the name of the patient, followed by their address, date of birth, city, zip code, and phone number in the corresponding fields.
5. If you wish to decline sharing immunization records, check the box indicating your refusal to allow records to be shared with other health care providers, agencies, or schools.
6. If you are changing your mind and wish to start sharing records, check the box allowing your or your child's immunization record to be shared.
7. If you need to request information, check the appropriate boxes to either request a list of agencies that viewed the records or to request corrections to the immunization record.
8. Sign the form and enter the date to validate your request.
9. After completing the form, ensure all information is accurate. You can then save your changes, download, print, or share the completed form as needed.

Complete your Decline Or Start Sharing Information Request Form CAIR online today.