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Requirements for Schools and Childcare Facilities

2021-2022 Immunization Reporting Packet

Reporting Forms and Due Dates

IMPORTANT: Save the forms to your computer before adding data or your numbers will not save.

Page 1: Section A English SpanishDue by January 12, 2022
Page 2: Section B-D English SpanishDue by January 12, 2022
Page 3*: Section E-G
English SpanishDue by February 28, 2022
Page 4: Section H English SpanishDue by February 28, 2022

*Can be submitted with Section A if no children are listed on Section B.

Most-used Resources

1. 2021-2022 Report Due Dates (pdf)
2. "School Bus" Flyers - What shots are needed for each grade.
3. Health Department Contact Information (pdf)
4. Checklist (fillable pdf)
5. Updated 2021!Immunization Law Handbook (Interim) (pdf)
6. Online Learning FAQs (pdf)
7. Training on immunization requirements, reporting, and using ALERT IIS
8. Sharing Your Immunization Rates

Getting and Reviewing Records

  1. Certificate of Immunization Status (CIS) form: The immunization record for each child
  2. ALERT IIS: Oregon immunization registry. A website to look up records and see if shots are due.
  3. Approved Computer Systems: A list of computer systems that have can review records and complete reports based on Oregon’s immunization requirements. (pdf)
  4. Primary Review Table: Detailed charts to manually review records (pdf)
  5. Vaccine Brand Names


  1. Exemptions: Medical, Nonmedical, Immunization Documentation
  2. Medical Exemptions Review form

Exclusion Order Explanations for Parents

  1. Understanding a No Record Exclusion Order
  2. Understanding an Incomplete/Insufficient Exclusion Order

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