Immunization Record Request Application - New York City (Haitian Creole)

Immunization Record Request Application - New York City (Haitian Creole)

This is a legal document that was released by the New York City Department of Health and Mental Hygiene - a government authority operating within New York City.

The document is provided in Haitian Creole.

FAQ

Q: What is the immunization record request application for?
A: The immunization record request application is for requesting immunization records.

Q: Who is the immunization record request application for?
A: The immunization record request application is for residents of New York City.

Q: Can I request my immunization records in Haitian Creole?
A: Yes, the immunization record request application is available in Haitian Creole.

Q: How can I get a copy of my immunization records?
A: You can request a copy of your immunization records through the immunization record request application.

Q: Is there a fee for requesting immunization records?
A: No, there is no fee for requesting immunization records in New York City.

Q: How long does it take to receive the requested immunization records?
A: It may take up to 30 days to receive the requested immunization records.

Q: Can I request immunization records for my child?
A: Yes, you can request immunization records for your child through the immunization record request application.

Q: What information do I need to provide when requesting immunization records?
A: You need to provide information such as your full name, date of birth, and contact information when requesting immunization records.

Q: Can I request immunization records for someone other than myself?
A: Yes, you can request immunization records for someone other than yourself if you have their written permission or are their legal guardian.

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Form Details:

  • Released on September 16, 2019;
  • The latest edition currently provided by the New York City Department of Health and Mental Hygiene;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New York City Department of Health and Mental Hygiene.

Download Immunization Record Request Application - New York City (Haitian Creole)

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