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Get Utah Department Of Health Community And Family Health Services Immunization / Usiis Program P O Box

W from the Utah Statewide Immunization Information System (USIIS) I, , wish to withdraw my child(ren) Parent or Guardian First and Last Name (please print) from the Utah Statewide Immunization Information System (USIIS). I understand that my child s/children s immunization records will not be included in USIIS and will not be shared through USIIS with authorized health care providers, health insurers, schools, day care centers, and.

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