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Nursing informatics / Immunization registry / Immunization / Anatomy / VacTrAK / Medicine / Health / Medical informatics


INSTRUCTIONS: 1. Complete this form. 2. Return both pages via fax to[removed]or mail to: 3. Immunization Section, 525 West Jefferson, Springfield, IL 62761
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Document Date: 2014-12-09 16:03:29

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File Size: 113,43 KB

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City

Springfield / /

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Facility

University Please / /

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IndustryTerm

electronic web-based immunization data registry / /

MedicalTreatment

Immunization / immunizations / /

Organization

Child Care Center / Child-Placing Agency / Secondary School / Local Health Department / Illinois Department of Public Health / /

Position

Representative / legal custodian / /

ProvinceOrState

Illinois / /

SocialTag