Order Form
School Immunization Materials
www.health.state.mn.us/divs/idepc/immunize/ordermat.html
Mail:
Phone:
Minnesota Department of Health
Immunization Program
P.O. Box 64975
St. Paul, MN 55164-0975
Fax:
1-800-657-3970
651-201-5503
651-201-5501
Agency
Street Address (No PO Boxes)
•
•
•
City
State
Phone
Contact
Zip
All materials are free of charge.
Most materials are on the web; some are only available on the web.
Subscribe to get an e-mail alert when there are major additions or updates to the MDH web page for school health personnel at
www.health.state.mn.us/divs/idepc/immunize/school/index.html.
Quantity
Limit
limit 10
Are Vaccines Safe?, National Network for Immunization Information, 18 pg booklet
ID# 53278
Are Your Kids Ready and When to get Vaccines, MDH, 2 pg flyer on immunizations needed by age and for enrolling in
child care, early childhood programs, and school in Minnesota.
No limit
www.health.state.mn.us/divs/idepc/immunize/schedules.html
______ English ID# 52799
Somali ID# 52950
no limit
Hmong ID# 52948
_
Spanish ID# 53669
_
_
Russian ID# 52949
Vietnamese ID# 53412
Ask About Free or Low Cost Shots, table tent with simple message in six languages, MDH
ID# 53527
Concerned About the Cost of Shots?, 11” x 17” MnVFC poster
no limit
_____ English ID# 53190
______ Spanish ID# 53229
Immunize for Life, MDH, 1 pg
no limit
(packs of 100)
no limit
ID# 53426 (MDH, 3/17)
______ English ID# 53469
______ Hmong ID# 53470
______ Russian ID# 52849
______ Somali ID# 52850
______ Spanish ID# 52851
______ Vietnamese ID# 52849
Minnesota Immunization Record "Gold Card," MDH, wallet-sized card
ID# 53887
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Order Form - School Immunization Materials
Quantity
Limit
no limit
Order Form – School Immunization Materials, 3 pgs, MDH
no limit
Teens Need Shots, Too!, 1 pg, MDH
no limit
2017 Recommended Childhood Immunization Schedule, 6 pgs, CDC/MDH
no limit
Reliable Sources of Immunization Information, 2 pg fact sheet, MDH
www.health.state.mn.us/divs/idepc/immunize/ordermat.html
www.health.state.mn.us/divs/idepc/immunize/adol/index.html
www.health.state.mn.us/divs/idepc/immunize/hcp/schedules.html
www.health.state.mn.us/divs/idepc/immunize/safety/imminfo.html
ID# 53426
ID# 53757
ID# 53454
ID# 53905
Comments or questions:
ID# 53426 (MDH, 3/17)
Page 2 of 3
Order Form - School Immunization Materials
Web-Only Immunization Materials for Schools
You can download and print these items from the website listed below them.
Can My Child Get Free or Low Cost Shots? 1 pg self-screening form for Vaccines for Children program, MDH
www.health.state.mn.us/divs/idepc/immunize/howpay.html
Chickenpox and Shingles Case Report Form for Minnesota Schools, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/varicella/school/schoolreporting.html
Chickenpox and Shingles: School Reporting and Outbreak Recommendations, 2 pgs, MDH
www.health.state.mn.us/divs/idepc/diseases/varicella/school/schoolrptrecs.html
Chickenpox (Varicella), 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/varicella/chknpxfacts.html
Early Childhood Immunization Form, form, MDH
Use this immunization form in place of the Early Childhood Family Education (ECFE) and Early Childhood Special Education (ECSE) forms
www.health.state.mn.us/divs/idepc/immunize/laws/ecplaw.html
Flu Symptom Screening Tool for Parents and Caregivers, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/flu/school/index.html
Got Your Shots? News, sign up to receive a monthly immunization update from the MDH Immunization Program
www.health.state.mn.us/divs/idepc/newsletters/gys/index.html
Immunization Record for Students Attending Post-Secondary Schools in MN, form, MDH
www.health.state.mn.us/divs/idepc/immunize/laws/postseclaw.html
Influenza in Schools, MDH, 1 pg
www.health.state.mn.us/divs/idepc/diseases/flu/school/fluschools.html
Influenza-like Illness Report Form – Minnesota Schools, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/flu/school/index.html
Meningococcal Disease and the Vaccine: What College Students Need to Know, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/meningococcal/collegefact.html
Meningococcal Vaccine: Why Preteens and Teens Should Get It, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/meningococcal/meningpreteen.html
MIIC and Schools, 1 pg, MDH
www.health.state.mn.us/divs/idepc/immunize/registry/schools.html
Minnesota's College Immunization Law, 2 pgs, MDH
www.health.state.mn.us/divs/idepc/immunize/laws/collegelaw.html
School Immunization Law in Minnesota
www.health.state.mn.us/divs/idepc/immunize/laws/schlaw.html
Pertussis and School Age Children: What Parents Need to Know, 1 pg, MDH
Available in English, Hmong, Russian, Somali, and Spanish
Pertussis in Schools, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/pertussis/pertparents.html
www.health.state.mn.us/divs/idepc/diseases/pertussis/school/pschoolfacts.html
Pertussis: School and Activities Exclusion Recommendations, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/pertussis/school/schoolexcl.html
Student Immunization Form, form, MDH
School Reporting of Vaccine-Prevenable Diseases, table, 1 pg, MDH
www.health.state.mn.us/divs/idepc/immunize/laws/schlaw.html
www.health.state.mn.us/divs/idepc/immunize/school/schoolreport.html
Tdap Vaccine: What Teens Need to Know, 1 pg, MDH
www.health.state.mn.us/divs/idepc/diseases/pertussis/tdapfsteens.html
Looking for Immunization Records? 1 pg, MDH
www.health.state.mn.us/divs/idepc/immunize/registry/immrecords.html
Using Lists in MIIC, 2 pgs, MDH
Varicella Disease History Verification Checklist, MDH, 2 pg template
www.health.state.mn.us/divs/idepc/immunize/registry/hp/lists.html
www.health.state.mn.us/divs/idepc/immunize/laws/schlaw.html
VISs (Vaccine Information Statements): What You Need to Know, 2-4 pg fact sheets on each vaccine, CDC
Available in many languages
www.immunize.org/vis
Comments or questions:
ID# 53426 (MDH, 3/17)
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