How to Fill Out and Submit the Washington State CIS Form

Washington’s Certificate of Immunization Status, known as the CIS form, is the one-page document every child needs on file before starting a public or private school, preschool, or licensed childcare in the state. You can get a Washington CIS form three ways: ask your child’s healthcare provider to print one from the state Immunization Information System (IIS), print one yourself through the MyIR online portal, or fill out a blank paper copy by hand. However you get it, the form has to be medically verified before a school will accept it, and without a verified CIS or a Certificate of Exemption, your child cannot start attending.¹²

Three Ways to Get the Form

The method you pick determines how much verification work you have left to do.

The easiest route is to ask your child’s healthcare provider to print a CIS from the IIS. If the provider enters immunizations into Washington’s statewide system, the printout arrives with your child’s vaccine history already filled in and counts as medically verified. No additional signature needed.³

You can also do this yourself. Create an account at myirmobile.com and link your child’s records. If the system finds a match, you can view and print the CIS at home. A CIS printed through MyIR pulls from the same IIS data and is also medically verified on arrival.⁴⁵

The third option is to fill out a blank paper form by hand. You can download the form from the Department of Health website or pick one up from your child’s school or doctor’s office. A hand-completed CIS is not verified on its own and requires an extra step before the school accepts it.³

If you can’t find your child’s records in MyIR and your provider doesn’t use the IIS, you can request a copy directly from the Department of Health at waiisrecords@doh.wa.gov or 1-866-397-0337.⁴

How to Fill Out the Paper Form by Hand

Gather your child’s immunization records from the doctor’s office first. You’ll need the exact date of every dose.

At the top of page one, print your child’s full legal name and date of birth, then sign as the parent or guardian.⁴
Write the date of each dose in MM/DD/YY format in the matching column. For a combination vaccine like Pediarix, which covers DTaP, hepatitis B, and polio in one shot, record the date separately under each disease category.
If your child had chickenpox instead of getting the varicella vaccine, a healthcare provider must verify the disease history and check the box in the Documentation of Disease Immunity section. A parent’s own statement of disease history is not accepted for children currently entering school.⁶
If your child has a positive titer (a blood test showing immunity) for any required disease, have the provider check the appropriate boxes in the Documentation of Disease Immunity section, sign the form, and attach the lab report.⁴

Every date must match your child’s medical records exactly. The school will compare the CIS against those records during verification, and a missing or incorrect date can flag your child as out of compliance.

Getting the Form Medically Verified

A CIS printed from the IIS, whether by your provider or through MyIR, is automatically medically verified. That’s the shortcut, and it’s worth asking your doctor about even if you’ve already started on a paper form.⁵

A hand-completed CIS becomes medically verified in one of two ways.

The first is a healthcare provider’s signature. Your child’s doctor, nurse practitioner, or other provider reviews the form, confirms the dates match their records, and signs it.³

The second is to attach copies of the actual medical vaccination records to the hand-completed CIS and let school staff verify it. The school nurse, administrator, or their designee can compare the documents and sign the CIS themselves. When school staff verify it this way, no separate provider signature is required.¹

That second option helps if you have printed records from a clinic that doesn’t use the IIS and you’d rather not schedule a separate office visit just for a signature. Bring the records and the CIS to the school registrar and ask staff to verify it on the spot.

Submitting the Form and What Happens Next

Once the CIS is medically verified, deliver it to the school registrar or childcare administrator. This is a prerequisite for attendance. Your child cannot start until the form is on file. If the record shows all required doses are complete, your child is cleared immediately.

Conditional Status for Children Still Catching Up

Children who are partway through a multi-dose series like hepatitis B or DTaP can still attend school under conditional status while waiting for the next dose. Conditional status runs on a rolling timeline: once the next dose’s minimum valid date arrives under the national catch-up schedule, you have 30 calendar days (not school days) to get the dose administered and turn in updated documentation.⁷

If your child needs several catch-up doses, the pattern repeats. Each time a dose comes due, the 30-day clock restarts for that dose. Once all required vaccines are complete, the status changes to “complete.”⁴

One grade-entry rule falls outside this flexibility: the Tdap booster for 7th grade entry must be received before the student starts school. There is no conditional status period for that requirement.¹

What a Lapse Looks Like

If the 30-day conditional period expires without updated documentation, the status changes to “out of compliance” and the school is legally required to exclude the child from attendance.² The school must give you written notice before excluding your child, and that notice has to explain the reason, how long the exclusion will last, what documentation is needed to return, and where to find immunization services through the local health department. The exclusion continues until you provide proof of vaccination, a completed Certificate of Exemption, or documentation showing your child has started a catch-up schedule.¹

If You’re Claiming an Exemption Instead

Washington allows three categories of exemption, each handled through a separate document called the Certificate of Exemption (COE). The COE is not a section of the CIS; it’s its own form.⁸

Medical exemption: a healthcare practitioner signs certifying that a particular vaccine is not advisable for your child. If the reason is temporary, the vaccine is required once the contraindication resolves.
Religious exemption: a parent or guardian signs stating that their religious beliefs are contrary to immunization.
Personal or philosophical exemption: a parent or guardian signs stating a personal objection. This category cannot be used for measles, mumps, or rubella (MMR).⁸

For all three types, the COE must include a signature from a licensed healthcare practitioner (an MD, DO, ND, ARNP, or PA licensed in Washington) confirming that they discussed the benefits and risks of immunization with you.⁹ The one exception is for families who demonstrate membership in a religious body whose teachings preclude medical treatment; in that case the practitioner signature is not required.⁸

A Note for Homeschool Families

The immunization requirement in RCW 28A.210.080 applies to children attending public and private schools and licensed daycare centers. Home-based instruction is not listed, and families who homeschool are not required to submit a CIS.² If a homeschooled student later transfers to a public or private school, immunization records must be forwarded along with other educational records, and the receiving school will require a completed CIS before the student can attend.¹⁰

1
Washington State Department of Health. School and Child Care Immunization
2
Washington State Legislature. RCW 28A.210.080 – Immunization Program
3
Washington State Department of Health. Medically Verified Immunization Records School and Child Care Staff Guide
4
Washington State Department of Health. Certificate of Immunization Status (CIS)
5
Washington State Department of Health. Washington State Immunization Information System
6
Washington State Legislature. WAC 246-105-040
7
Washington State Department of Health. Frequently Asked Questions About Conditional Immunization Status
8
Washington State Legislature. RCW 28A.210.090 – Immunization Program Exemptions
9
Washington State Department of Health. Certificate of Exemption
10
Washington State Legislature. RCW 28A.200.010