Immunization Card Template

Immunization Card Template

What Is an Immunization Card?

An Immunization Card is a document that can be used to verify that the holder of the card has undergone certain types of vaccinations. The purpose of the card is to confirm that the individual has been vaccinated and provide information about the individual's immunization.

Alternate Names:

  • Flu Shot Verification Form;
  • Proof of Flu Shot Form;
  • Vaccine Record Form.

This type of card can be required when you apply for certain types of jobs, when you travel to particular destinations, or when you simply want to send your child to a kindergarten or to a school. Generally, the cards are prepared by the medical organization where the individual has undergone a vaccination. An Immunization Card template can be downloaded below.

The way this card looks and what is included in it can depend on the country or state where it was issued. Some cards contain information about all of the immunizations the individual has throughout their life, others include information only about a specific vaccination.

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How to Get a New Immunization Card?

If you want to develop a form for this kind of record for use in your medical organization, you should first check with the local authorities in case there are any requirements to the format and the content of this document. After that, you can look for a blank Immunization Record Card online to see the different variations of how these cards can look and what they can include. When you choose one and decide to go with it, make sure your record contains the following parts:

  1. Information About the Individual . Here, the individual who has undergone vaccination (the cardholder) is required to state their full name and address.
  2. Information About the Medical Organization . This section should be filled out by the representative of the medical organization. They are supposed to designate the name of the organization and its location. Commonly, organizations develop a template for such kind of document and use it with all of their patients. Therefore, most of the time the information is already printed out on the card.
  3. Vaccine Details . In this part of the document, the medical specialist that vaccinated the cardholder must indicate the name of the vaccine that has been administered, the name of the person who administered it, the vaccine's manufacturer, its expiration date, and other details.
  4. Signatures . The card can be signed by the cardholder and by the medical specialist that has vaccinated them. It will verify their identities and the content of the document.

Nowadays many immunization documents are prepared and kept electronically, therefore, if you want your vaccination card to be digital as well you can contact the medical organization that has issued it and ask them for details.


Haven't found the template you're looking for? Take a look at the related templates below:

Download Immunization Card Template

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  • Immunization Card Template - A customizable document for tracking vaccination records and immunizations.
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