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Form IMM-43 Immunization Registry (Webiz) Authorization to Release Official Immunization History - Arkansas
What Is Form IMM-43?
This is a legal form that was released by the Arkansas Department of Health - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is form IMM-43?
A: Form IMM-43 is the Immunization Registry (Webiz) Authorization to Release Official Immunization History in Arkansas.
Q: What is Webiz?
A: Webiz is the Immunization Registry system in Arkansas.
Q: What is the purpose of form IMM-43?
A: The purpose of form IMM-43 is to authorize the release of official immunization history from the Webiz Immunization Registry in Arkansas.
Q: What does form IMM-43 require?
A: Form IMM-43 requires personal information such as name, date of birth, and contact information, as well as a signature.
Q: Why would I need to fill out form IMM-43?
A: You may need to fill out form IMM-43 to provide your official immunization history to a specific entity or individual for various purposes.
Q: Is form IMM-43 mandatory?
A: Form IMM-43 is not mandatory, but it may be required in certain situations or for specific requests.
Form Details:
- Released on October 1, 2022;
- The latest edition provided by the Arkansas Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form IMM-43 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Health.
