New Hampshire Immunization Information System (Nhiis) Withdrawal Form - New Hampshire

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New Hampshire Immunization Information System (Nhiis) Withdrawal Form - New Hampshire

New Hampshire Immunization Information System (Nhiis) Withdrawal Form is a legal document that was released by the New Hampshire Department of Health and Human Services - a government authority operating within New Hampshire.

FAQ

Q: What is the New Hampshire Immunization Information System (NHIIS)?
A: The NHIIS is a database that stores immunization records for residents of New Hampshire.

Q: What is the purpose of the NHIIS withdrawal form?
A: The NHIIS withdrawal form is used to request that your immunization records be removed from the NHIIS database.

Q: Why would someone want to withdraw their immunization records from the NHIIS?
A: There may be various reasons why someone would want to withdraw their immunization records, such as personal preference or privacy concerns.

Q: Is there a deadline for submitting the NHIIS withdrawal form?
A: There is no specific deadline for submitting the NHIIS withdrawal form, but it is recommended to do so as soon as possible.

Q: What information do I need to provide on the NHIIS withdrawal form?
A: You will need to provide your personal information, such as your name and contact information, as well as the information of the person whose records you want to withdraw.

Q: Can I withdraw the immunization records of someone else?
A: Yes, you can withdraw the immunization records of someone else if you have their consent and provide their information on the withdrawal form.

Q: What happens after I submit the NHIIS withdrawal form?
A: Once you submit the NHIIS withdrawal form, your request will be processed, and the immunization records will be removed from the NHIIS database.

Q: Can I request a copy of the immunization records being withdrawn?
A: Yes, you can request a copy of the immunization records being withdrawn at the time of submitting the NHIIS withdrawal form.

Q: Who should I contact if I have further questions about the NHIIS withdrawal process?
A: You should contact the New Hampshire Immunization Program for further questions about the NHIIS withdrawal process.

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Form Details:

  • Released on July 1, 2022;
  • The latest edition currently provided by the New Hampshire Department of Health and Human Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services.

Download New Hampshire Immunization Information System (Nhiis) Withdrawal Form - New Hampshire

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