Schools and child care centers require a specific Washington State Department of Health Certificate of Immunization Status (CIS) form for your child’s entry. This requirement can be met by writing the dates that we can provide from our immunization history (see example) to the CIS form. With our patient volume, we will not be able to fill out the form for you, nor retrieve the form from the CIS website. Rather than filling out the CIS by hand, you can get a CIS from the IIS in the following ways:
Parents can sign up for MyIR to view, download, and print their child’s CIS. For steps on how to access MyIR visit:

Send an email to the Department of Health to request a CIS. The email is