Colorado Immunization Branch Materials Order Form

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Immunization Record Cards

UPDATE** Immunization Administration Card for Child or Teen - We are no longer printing and sending out this form. This form can now be download and printed here: Vaccine Administration Records for Child or Teen http://www.immunize.org/catg.d/p2022.pdf
 
 This form is used in a provider's office as a means of creating a permanent record of immunizations.
UPDATE** Immunization Administration Card Expanded for Adults - We are no longer printing and sending out this form. This form can now be download and printed here: Vaccine Administration Records for Adults http://www.immunize.org/catg.d/p2023.pdf

This form is used in a provider's office as a means of creating a permanent record of immunizations.  This form also contains space for travel related immunizations.
Child and Teen Immunization Record Card - Yellow card stock, quad fold to 2" x 3"
These cards are provided to parents as a permanent record of a child's immunization history.
 
Only clinics are allowed to distribute these Record Cards. We are running low on these cards and will be on backorder soon, please order only what you need for the next two months. 
Note: These cards were updated in February 2022.
Adult Immunization Record Card- Purple card stock, tri-fold to credit card size
This form is given to an adult patient as a record of immunizations.  
Only clinics are allowed to distribute these Record Cards. We are running low on these cards and will be on backorder soon, please order only what you need for the next two months. 
Note: These cards were updated in February 2022.
Lifetime Immunization Record Card- Green card stock, tri-fold to credit card size
This form is given to a patient as a record of immunizations.  
Only clinics are allowed to distribute these Record Cards. We are running low on these cards and will be on backorder soon, please order only what you need for the next two months. 
Note: These cards were updated in February 2022.

2022 Child and Adolescent Laminated Immunization Schedule

2020 U.S. Recommended Child and Adolescent Immunization Schedule to place in exam rooms. 8 panels that fold down to 8 1/2" X 11"

2022 Adult Laminated Immunization Schedule

2020 U.S. Recommended Adult Immunization Schedule to place in exam rooms. 6 panels that fold down to 8 1/2" X 11"
 

During Pandemic Stay Current With Vaccines Resources

Parent Postcard - 4" X 6" postcard - These postcards remind parents that it is important to immunize their children during the pandemic.
For the original image of the Parent Postcard or to see it in other languages link to https://www.colorado.gov/pacific/cdphe/child-cares-schools-and-collegesuniversities-immunization-resources


Parent Flyer - 8 1/2" X 11" - This flyer hangs on any door or wall and reminds parents of the importance of vaccinating their children during the pandemic.
For the original image of the Parent Flyer or to see it in other languages link to https://www.colorado.gov/pacific/cdphe/child-cares-schools-and-collegesuniversities-immunization-resources

Reminder Cards - Your practice "Notice of Privacy" must state that cards may be sent to use the following items

Folding Reminder Card - English -While supplies last. When this item runs out, they will no longer be printed. Purple card stock, folded to 5.5" x 4.5"
These cards are to be used to notify a parent of a specifically needed immunization via mail.
Folding Reminder Cards - Spanish -While supplies last. When this item runs out, they will no longer be printed.  Yellow card stock, folded to 5.5" x 4.5"
These cards are to be used to notify a parent of a specifically needed immunization via mail.
Reminder Card -English -While supplies last. When this item runs out, they will no longer be printed.  Pink card stock, 5.5" x 4.5"
These are post card sized reminders that only list a child's name and contact info for the practice
Reminder Card -Spanish - While supplies last. When this item runs out, they will no longer be printed. Peach card stock, 5.5" x 4.5"
These are post card sized reminders that only list a child's name and contact info for the practice

Colorado Immunization Information System (CIIS) materials

PROVIDER Notification Poster -
This poster is recommended to be displayed in all practices who utilize the CIIS system. 
This poster has been updated to include more languages and will no longer be available for order. You may find and print the updated poster here: https://www.colorado.gov/pacific/cdphe/statutory-notice-patients-right-opt-out