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Requests for Immunization Records in ImpactSIIS,
www.ohiopublichealthreporting.infoOhio Dept of Health 1-866-349-0002 ImpactSIIS Help Documentation 1 May 5, 2016 Requests for Immunization Records in ImpactSIIS, Ohio’s Immunization Registry
Authorization to Disclose Health Information
www.ohiopublichealthreporting.infoColumbus, Ohio 43215 U.S.A. www.odh.ohio.gov The State of Ohio is an Equal Opportunity Employer and Provider of ADA Services. Authorization to Disclose Health Information Name _____ Date of Birth_____
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