If your child is current on their physical exam (well child check), you can request a Child Health Assessment form. This document is from The Kansas Department of Health and Environment (KDHE) and therefore accepted by all local daycares and schools.

You can also request your child’s immunization records using this page.

Please fill out the request below. Do not refresh the page before submission.

Child Health Assessment/Immunization Record Request for Schools and Daycares

Please allow approximately two business days to complete.

Immunization records can be picked up by authorized people Monday to Friday from 8:00 AM to 4:30 PM without prior request.


Well checks:

  • 2 weeks | 2 months | 4 months | 6 months | 9 months | 12 months | 18 months | 2 years
  • Children above two years old: yearly

The request above is for paperwork for schools and daycares.
If you wish to obtain medical records or have them sent to another healthcare provider, please fill out a release (PDF only) and mail/fax/upload it after signing the form.