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Immunization School and Childcare Requirements Recommended Schedule Preteen Vaccines Adult Vaccines Travel Immunization Clinic Immunization Registry Order Materials Other Resources

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Services > Immunization > Immunization Materials Schools and Childcare Order Form

Immunization Materials Schools and Childcare Order Form

Instructions

Please use this form to order Immunization Supplies. Please indicate address and contact information. Fax completed form to Connie Ward at 925-313-6036.

Fax Order Form (116k PDF, 2p.)

Online Order Form

For further information or assistance contact the Immunization Program at 925-313-6767.

Content provided by the Public Health Division of Contra Costa Health Services.