Immunization Consent Forms

Consent Forms

Download the appropriate form found below. Complete and sign the form and bring it with you to your appointment  at the Public Health Department. Find your previous immunization records through California Department of Public Health.

Caregiver Consent

If you are unable to accompany your child to an Immunization Clinic, please download, complete and sign the Immunization Consent Form and the Caregiver Consent or Designation of another Person to Consent for Immunizations below. Have the caregiver bring both completed forms and the child's immunization records with them to the clinic!