Forms
Certificate of Exemption from Immunization (English)
Immunization - Form
January 26, 2026
This form may be used by individuals requesting a religious or medical exemption to immunization for their children whom attend any public, private or parochial pre-school, kindergarten, elementary, secondary school, or home school and for children attending daycare of childcare facilities.
Certificate of Exemption from Immunization (Spanish)
Immunization - Form
January 20, 2026
This form may be used by individuals requesting a religious or medical exemption to immunization for their children whom attend any public, private or parochial pre-school, kindergarten, elementary, secondary school, or home school and for children attending daycare of childcare facilities.
VFC Vaccine Administration Form (Part B)
Immunization - Form
August 13, 2025
This form allows you to provide immunization information for entry into NMSIIS.
NMSIIS Organization Security and Confidentiality Agreement 2026
Immunization - Form
January 2, 2025
Participant organization security and confidentiality agreement for the New Mexico Statewide Immunization Information System.
NMSIIS User Security and Confidentiality Agreement 2026
Immunization - Form
January 2, 2025
NMSIIS User Security and Confidentiality Agreement 2026
NMSIIS Decision to Remove Record
Immunization - Form
December 30, 2021
This form is used by a patient/parent/legal guardian to remove records from the New Mexico Statewide Immunization Information System.
NMSIIS Decline to Participate Form
Immunization - Form
December 30, 2021
This form is used by a patient/parent/legal guardian to decline to participate in the New Mexico Statewide Immunization Information System.