Please read the first five headings below and click on the link to the document that best describes where you work.

• ASIIS Enrollment Forms
  • People who work in a school PDF | DOC (PLEASE FAX BACK ALL THREE PAGES!)
  • People who work in a daycare center PDF | DOC (PLEASE FAX BACK ALL THREE PAGES!)
  • CPS employees PDF | DOC
  • People who work in a vaccine provider’s office that USE the free state-supplied VFC vaccine PDF | DOC
  • People who work in a vaccine provider’s office who DO NOT use the free state-supplied VFC vaccine PDF | DOC
• The Law (Arizona Revised Statute (A.R.S. § 36-135)
• The Rule (Arizona Administrative Code (AAC) R9-6-706 and 707)

To enroll with the ASIIS program, fill out the ASIIS enrollment Application and ASIIS User Agreement. These documents may be mailed or faxed to:

Arizona Immunization Program Office/ASIIS
150 N. 18th Avenue
Phoenix, AZ 85007
(602) 364-3899
(602) 364-3285 (Fax)
 

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