The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

DYC8GqdsxKoSyVx3MtuVQEReCtdLMxtRqMWTMEGsCYwT6zi68MKmEAJKpQzhaTbzjjZTUrkMX8U9G2PGgoH

MIIC Privacy Setting Change Request

The Minnesota Immunization Information Connection (MIIC) is a statewide immunization information system that stores electronic immunization records. The information in MIIC is used to help improve vaccination practice and prevent vaccine-preventable diseases in Minnesota. MIIC information is classified as private and only those authorized by law (Minnesota Statutes, Section 144.3351) can see it.

This form allows you to change your or your child's MIIC privacy settings. Options include: choosing not to receive MIIC-based immunization reminders, locking the record so no authorized users besides your health care facility can see it, or choosing to opt-out of MIIC. Individuals who choose to opt-out of MIIC will not be penalized. For more information on these settings, go to Data Privacy and MIIC Records.

Complete the following form to change your or your child's MIIC privacy settings. If you do not want to provide your information electronically, you can still change your or your child's MIIC privacy settings by contacting the MIIC Help Desk at health.miichelp@state.mn.us. To stop receiving immunization reminders from your health care facility, contact your doctor/primary care provider.

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