New York City Bureau of ImmunizationCitywide Immunization Registry (CIR)Record Assistance Request Form Survey

Please complete the form below if you were unsuccessful in accessing your or your child’s immunization record using the New York City-Citywide Immunization Registry (CIR) My Vaccine Record (MVR) online application. This includes COVID-19 and mpox vaccination records. Please allow two business days for a reply. To complete this form, you will need your photo ID and any supporting documents. If you have already completed an Immunization Record Request Application (PDF) (additional languages), you may upload it here.

Please note your provider can review and add missing immunizations to your record.

CIR staff will review the information you submit and your request. You will be contacted if more information is needed.

If you are inquiring about records for more than one individual, please fill out a separate form for each individual.

For general questions about immunization records, contact NYCvaxrecord@health.nyc.gov.

Reason for request: (Select all that apply)

You will be able to describe your request in detail later.(Required.)

CIR Immunization Record

Other (please specify)

New York City Bureau of Immunization
Citywide Immunization Registry (CIR)
Record Assistance Request Form