School/Early Childhood Program Order Form

Date: Organization:
Name: Address:
City: State:   Zip:
Phone: Fax:

Please order the exact quantities sufficient for a three-month period English Spanish
Record Cards Utah School Immunization Record hard copy will be mailed ONLY to
Head Start Programs & Child Care facilities. Schools can print
the Utah School Immunization Record from the link below - It can
be printed on any color paper. English
Schedule Cards Adolescent English | Spanish
Childhood English | Spanish
Childhood 8.5 x 11 English | Spanish  
Posters Back to School Imm Requirements Poster 11 x 17  
Preteen Doctor Visit 12 x 20
Got Vaxed Poster Teenagers 14 x 20  
Got Vaxed Poster Question Mark 14 x 20  
Vaccinate Before You Graduate 11 x 17  
Brochures A Guide for Parents about USIIS English | Spanish
Hepatitis A What You Should Know
Hepatitis B - Stop the spread
Got Vaxed Adolescent English | Spanish
Preteen Doctor Visit English | Spanish  
Protect Children by Protecting Yourself English | Spanish
Questions and Answers: A Guide for Parents about Childhood
Vaccinate Before You Graduate English | Spanish
Your Child & Vaccine Safety
Please verify your order by entering the random letters (case sensitive) displayed in this image:

Contact Tammy Gresham with any questions (801) 538-9450. Include exact quantities sufficient for a three-month period. Due to limited inventory, your order may be adjusted.

Printable Utah School Immunization Record card here: Utah School Immunization Record