Sumner County Immunization Record Transfer

Educational institutions and daycare/preschool facilities require students to show proof of immunization against certain preventable communicable illnesses. The State of Tennessee currently provides immunization records on an official certificate issued by local health departments or by primary care providers who participate in the online immunization information system. All new immunization records must be MANUALLY TRANSCRIBED by department staff. Please allow 1-2 business days for processing. Submissions received after 4:00pm will be processed the next business day.

Health Dept Immunization Record Transfer

Parent/Guardian/Caregiver Information

Guardian Name
Guardian Name
First
Last
Address
Address
City
State/Province
Zip/Postal

Child/Student Information

Maximum upload size: 268.44MB

By providing your digital signature you are agreeing to the following:

I certify that I am the legal guardian or person legally designated to make healthcare decisions on behalf of the above named child and that all information provided is true and accurate to the best of my knowledge. I authorize the Sumner County Health Department to access, update and or create the above named child's record for official use and release the record in-person, by mail or email.