OSIIS - Authorization to Use or Share Protected Health Information to School.
I hearby authorize the Oklahoma Immunization Service to release my Immunization records and information located within the Oklahoma State Immunization Information System (OSIIS) to Glenpool Public Schools.
The informaion may be disclosed to to ensure the student meets Oklahoma eligibility requirements for schools/day cares as outlined in Title 70 O.S. §
1210.191 and Oklahoma Administrative Code ("OAC") 310:535-1-2 and OAC 310: 535-1-3
This authorization will be in effect for one year from the date of signature.