Dear Parent or Guardian,

Kentucky  has a statewide immunization registry (KYIR) that medical practices use to help keep track of their patient’s immunizations. They use this system to record vaccines given to their patients and track immunizations that may have been given at other medical offices to ensure doctors give the correct vaccines at the correct times, and also remind patients when their vaccines are due.

The information on KYIR is confidential- only authorized users may access the system. Authorized users include the Health department, medical practices, schools, childcare facilities, WIC Programs and healthcare plans.

Some records in KYIR may be incomplete or missing because an immunization was given in another state or because the medical practice did not enter it into the system. Your child’s school wishes to help improve our community’s records by providing missing immunization information to KYIR, but requires your permission to do so, in accordance with the Family Educational Rights and Privacy Act. (FERPA).

By signing this form, you are helping to ensure that your child's immunization registry stays up to date, and also making it easier to ensure your child received their recommended vaccinations at the correct time.

Thank you,
Your School Nurse Health Team