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Breadcrumb

Request for Immunization Records

Required

This request authorizes Wylie ISD Health Services to provide a copy of immunization records. Any immunization records on file will be sent in the manner selected below. Former students who are 18 years or older must request their own immunization records. If you are requesting records during the school year for a current student, please contact their home campus.
Student's Namerequired
First Name
Middle (optional)
Last Name
Name of Last Wylie ISD School Attended
Must contain a date in M/D/YYYY format

Delivery Method Information
xxx.xxx.xxxx
xxx.xxx.xxxx
Please select the method you wish the records to be providedrequired