If you are unable to access your Minnesota Immunization Information Connection (MIIC) immunization record through Docket , please fill out this form. The Minnesota Department of Health (MDH) will verify and update your immunization record, or the record for the person that you are the parent/guardian of, so that you can access the record using the Docket application.

Learn more about MIIC at MIIC and the Public.

MDH is collecting this data to allow you to access your immunization records, or the records for the person you are the parent/guardian of, using the Docket application. The Docket application allows a person to access their immunization record, or the record of a person they are the parent/guardian of through MIIC. The information you provide will be used to ensure your MIIC client information is up to date and accurate. Only MDH, your health care provider, and those authorized under law will have access to this information.

You are not legally required to provide this information, but if you do not provide the requested information, we will not be able to update the immunization record so that you can access it through the Docket application.

Once you have submitted your request, MDH will process the request within 14 business days. Requests will be processed in the order they are received. A confirmation email will be sent once the MIIC record has been updated.

This form is for people who are planning to access their records using the Docket application.

If you have any questions about MIIC record requests, please email Health.immrecords@state.mn.us.

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