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RICAIR Immunization Record Release Form 3 Capitol Hill Providence, RI 02908 Phone: 4012224644 Fax: 4012225734 Email: RIDOH.RICAIR@health.ri.govAUTHORIZATION TO RELEASE IMMUNIZATION RECORDS Patients
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How to fill out ricair immunization record release

01
Obtain the RICAIR immunization record release form.
02
Fill out your personal information including your full name, date of birth, and contact information.
03
Provide any relevant details about your immunization history including dates and types of vaccines received.
04
Sign and date the form to authorize the release of your immunization records.
05
Submit the completed form to the appropriate healthcare provider or organization.

Who needs ricair immunization record release?

01
Individuals who require proof of their immunization history for school enrollment, employment, travel, or other purposes.
02
Healthcare providers, schools, employers, and other organizations that need to access an individual's immunization records for medical or administrative reasons.
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RICAIR Immunization Record Release is a form used to authorize the release of immunization records to specific individuals or organizations.
Parents or legal guardians of minors are typically required to file RICAIR Immunization Record Release forms.
RICAIR Immunization Record Release forms can be filled out by providing the required information about the individual whose records are being released and signing the form.
The purpose of RICAIR Immunization Record Release is to allow individuals or organizations to access a person's immunization records for various reasons, such as school enrollment or travel.
RICAIR Immunization Record Release typically requires information such as the person's name, date of birth, and the specific records being released.
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