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  • Immunization Record Request Form

  • Thank you for using our online form to request immunization records.

     📌 Before you continue:

    • Please have a valid photo ID ready to upload (driver’s license, state ID, or passport).
    • If you’re missing records, check out our tips on tracking them down on the next page!

  • About imMTrax & Immunization Records

  • 📍 imMTrax is Montana’s statewide immunization registry, serving as a permanent & secure system for tracking immunization records.

    ⚠️ Unlike some countries, the U.S. does not have a national immunization database. This means your records may be stored in different places, such as:

    🏥 Healthcare providers (doctor’s offices, urgent care, pharmacies)
    🎓 Schools & universities (high schools, colleges)
    📁 State or county health departments

    If you received vaccines in another state or country, they are NOT automatically entered into imMTrax.

    To keep your records complete, we can add your immunization history once you provide official documentation. This ensures your records are accessible and up-to-date for future vaccinations.

  • Finding your immunization records

  • 📌 Before submitting your request, try these steps to locate your immunization records:

    ✔ Call your old high school – Some keep records for up to 60 years!
    ✔ Check with your college or university – They may have records on file.
    ✔ Contact your doctor’s office, urgent care, or pediatrician – Even if you haven’t been there in years, they might still have your records.
    ✔ Reach out to the health department where you grew up – They might have your records or direct you to the right place.
    ✔ Check state immunization registries – Some states have central databases.


    📄 If they cannot send records directly to you, have them faxed to us at: 406-582-3112

     

    🔍 Need more tips? Check here: Tips for Locating Old Immunization Records from Immunize.org

     

  • Record Request Type

  • Immunization Recommendation Review

  • Patient and Contact Information

  • Person Whose Records Are Being Requested

  •  - -

  • Requester's Information

    (Person Making the Request)

  • Contact Information

  • Upload Photos or Files for Entry into imMTrax

  • Please upload clear pictures or files of any immunization records you would like us to enter into imMTrax.

    ⚠️ Important: Each file must include the patient’s name and date of birth to ensure accurate record entry.

    📎 Accepted file types: PDF, JPG, PNG

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  • Identity Verification

  • Upload a valid photo ID (PDF, JPG, or PNG):

    Accepted forms of ID: Driver’s License, State ID, or Passport

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