County Public
Health Contacts
Find Us on Facebook

Follow IDPH on Twitter
Medical Home System Advisory Council
Skip to page content

Forms and Downloads

The Iowa Department of Public Health Immunization Program offers free print products to assist you in education of parents, providers, and general public on immunization issues.

There are three ways to order the products listed on this page:

  • Complete the ordering amounts and shipping information on this page and products will be sent directly to you, or
  • Complete the Literature Order Form and fax it to 866-499-8846. Orders must have a cover sheet stating ATTN: ISAIC
  • Order can also be placed at http://healthclrhouse.drugfreeinfo.org/

If you have questions about the products on this page please call the Immunization Program at 1-800-831-6293.

Preview
Click to view file as a PDF.
Some files are large and will take time to load.
DescriptionQuantity
Immunization Cards and Certificates
Certificate of Immunization (White 8½ X 11) Cardstock

This certificate is the official Certificate of Immunization required for children entering licensed child care and school.

Certificate of Immunization (White 8½ X 11) Paper

This certificate is the official Certificate of Immunization required for children entering licensed child care and/or school.

Provisional Certificate of Immunization (White 8½ X 11) Paper

This certificate is the official Provisional Certificate of Immunization to be used when a child has begun but not completed the vaccines required for entry into licensed child care and/or school.

Religious/Medical Exemption (White 8½ X 11) Cardstock

This certificate is the official Certificate of Immunization Exemption for medical or religious reasons for children entering licensed child care and/or school.

Standard immunization Parent Record (White 4 x 6)

This small card is designed for parents to record their child's immunizations for future reference. It is not an official Certificate of Immunization.

Master Index Card (White 8½ X 11)

This index card is designed for health care providers to maintain information regarding immunizations. It is not an official Certificate of Immunization.

Adult immunization Record (Ivory 6 3/8 X 3 3/8)

This small folded card will fit in a standard wallet and is designed for adults to record their immunizations for future reference. It is not an official Certificate of Immunization.

Pamphlets
Infant Immunization Pamphlet

This folded 3¾ x 8½ brochure outlines the recommended infant immunizations. It is recommended for general public use.

Adolescent Immunization Pamphlet

This folded 3¾ x 8½ brochure outlines the recommended adolescent immunizations. It is recommended for general public use.

Adult Immunization Pamphlet

This folded 3¾ x 8½ brochure outlines the recommended adult immunizations. It is recommended for general public use.

Influenza Immunization Pamphlet

This folded 3¾ x 8½ brochure outlines influenza immunization recommendations for all ages. It is recommended for general public use.

Iowa Immunization Law and You Pamphlet

This folded 3¾ x 8½ brochure outlines Iowa Immunization Law including the required immunizations for entry into licensed child care and/or school and the types of immunization certificates available in Iowa. It is recommended for general public use.

Hepatitis B Immunization Pamphlet

This folded 3¾ x 8½ brochure outlines the recommendations for hepatitis B vaccination for children. It is recommended for general public use.

Perinatal Hepatitis B Provider Tri Fold Pamphlet

This folded 3¾ x 8½ brochure outlines the recommendations for caring for a hepatitis B positive mother and/or infant as well as testing recommendations for all pregnant women. This brochure is recommended for providers and not for general public use.

Infant Immunization Pamphlet - Spanish

This brochure is currently unavailable.

This folded 3¾ x 8½ brochure outlines the recommended infant immunizations. It is recommended for general public use.

Adolescent Immunization Pamphlet - Spanish

This folded 3¾ x 8½ brochure outlines the recommended adolescent immunizations. It is recommended for general public use.

Adult Immunization Pamphlet - Spanish

This folded 3¾ x 8½ brochure outlines the recommended adult immunizations. It is recommended for general public use.

Influenza Immunization Pamphlet - Spanish

This folded 3¾ x 8½ brochure outlines influenza immunization recommendations for all ages. It is recommended for general public use.

Hepatitis B Immunization Pamphlet - Spanish

This folded 3¾ x 8½ brochure outlines the recommendations for hepatitis B vaccination for children. It is recommended for general public use.

Posters
Poster - Immunize for a Better LifePoster - Immunize for a Better Life - Spanish

This 17x22 poster features our "Immunize for a Better Life" campaign theme and a variety of people of different ages and backgrounds. It is intended to encourage age-appropriate vaccination.

Poster - Immunize for A Better Life - (17 x 22)

This 17x22 poster features our "Immunize for a Better Life" campaign theme and a variety of people of different ages and backgrounds. It is intended to encourage age-appropriate vaccination.

Poster - Influenza Health Care Provider - (17 x 22)

This 17x22 poster features our "Immunize for a Better Life" campaign theme and a variety of health care workers of different ages and backgrounds. It is intended to encourage influenza vaccination in health care workers.

Poster - Influenza Health Care Provider Clinic Scheduler (11 x 17)

This 11x17 poster features our "Immunize for a Better Life" campaign theme and a variety of health care workers of different ages and backgrounds. It is intended to encourage influenza vaccination in health care workers. It has a space at the bottom of the poster to enter facility specific information regarding influenza vaccination clinic dates and times.

Poster - Influenza Public (17 x 22)

This 17x22 poster features our “Immunize for a Better Life” campaign theme and a variety of people of different ages and backgrounds. It is intended to encourage the public to receive flu vaccination.

Poster - Influenza Public Clinic Scheduler (11 x 17)

This 11x17 poster features our “Immunize for a Better Life” campaign theme and a variety of people of different ages and backgrounds. It is intended to encourage the public to receive flu vaccination. It has a space that the bottom of the poster to enter facility specific information regarding flu clinic dates and times.

The Flu Ends With U poster

This is the poster that is part of the statewide “The Flu Ends With U” media campaign.

Vaccines for Children
Patient Eligibility Public Provider - English

This 8½ x11 form is used to screen children for eligibility in the VFC program. It is intended for use in a public clinic setting.

Patient Eligibility Private Provider - English

This 8½ x11 form is used to screen children for eligibility in the VFC program. It is intended for use in a private clinic setting.

Temperature Log Chart - Fahrenheit

This 8½x11 temperature log is designed to chart one month of refrigerator and/or freezer temperatures in Fahrenheit. It is designed for use for any setting that is storing vaccine.

Temperature Log Chart - Celsius

This 8½ x11 temperature log is designed to chart one month of refrigerator and/or freezer temperatures in Celsius. It is designed for use for any setting that is storing vaccine.

Patient Eligibility Private Provider - Spanish

This 8½ 11 form is used to screen children for eligibility in the VFC program. It is intended for use in a private clinic setting.

Patient Eligibility Public Provider - Spanish

This 8½x11 form is used to screen children for eligibility in the VFC program. It is intended for use in a public clinic setting.

IRIS
IRIS Reminder/Recall Postcards

This 8½x11 cardstock sheet has four perforated postcards on each sheet. It is designed to be used by clinics that are using IRIS to print out reminder/recall postcards for clients.

Vaccine Information Statements
** Notice on Vaccine Information Statements

Vaccine Information Statements (VIS) are designed for use by facilities (public and private) administering vaccine. It is federal law that patients are provided a VIS and have the opportunity to ask questions regarding the vaccine to be administered. The VISs listed here are available for clinics in bulk. If single VISs are desired, please visit the CDC Web site to download the most current VIS.


Shipping Information

Fields that are marked with an asterisk (*) are required.