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HUNTERImmunization Records 695 Park Avenue, 307 North, New York, NY 10065 T: 212.772.4800 | F: 212.650.3254, 212.396.6703 Wellness@hunter.cuny.eduThe City University of New YorkCONSENT TO RELEASE
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How to fill out consent to release immunization

How to fill out consent to release immunization
01
Obtain the consent form from the healthcare provider or organization requesting the release of immunization records.
02
Fill out the personal information section of the form, including name, date of birth, and contact information.
03
Provide details of the specific immunization records to be released, including dates of immunizations and types of vaccines received.
04
Sign and date the consent form to authorize the release of the immunization records.
05
Submit the completed form to the healthcare provider or organization requesting the information.
Who needs consent to release immunization?
01
Anyone who is required to provide proof of immunization to a school, employer, or other organization may need to fill out a consent form to release their immunization records.
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What is consent to release immunization?
Consent to release immunization is a form that allows the release of immunization records to a specified recipient.
Who is required to file consent to release immunization?
Parents or legal guardians of minors are typically required to file consent to release immunization forms.
How to fill out consent to release immunization?
Consent to release immunization forms can typically be filled out by providing personal information and signing the form.
What is the purpose of consent to release immunization?
The purpose of consent to release immunization is to authorize the release of immunization records to third parties.
What information must be reported on consent to release immunization?
The information reported on consent to release immunization forms typically includes the individual's name, date of birth, and immunization history.
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