Have you lost your COVID-19 vaccination record? We can provide you with a new one.
Please select from the options below and submit a form with your or your child's information. We will contact you within 7-10 business days.
I am an
Erie Patient
I am NOT
an Erie Patient
Vaccine Record Request Form for established Erie patients
If you are an Erie patient, please fill out the form below.
Vaccine Record Request Form for Community Members
If you are NOT an Erie patient, please fill out the form below.
Call (312) 666-3494 to schedule an appointment.
For our suburban locations call (847) 666-3494
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