Download Childhood Immunization Record for Free

The Childhood Immunization Record has a completed list of the vaccines that are necessary to the child. Every age group has the corresponding vaccine name, dose, description of the immunization, and the date being given the vaccine, which will help you save time and avoid the omission. Besides the general vaccines, there are also some other shots that depend on the child's health condition. At the end of the template, there are some instructions on the immunization. This template is offered for free.

(4.8 based on 883 votes)
Childhood Immunization Record
My child's name is My child's birthday is
My child's doctor is The doctor's phone number is
Age Immunization Dose Notes Date given
Birth
Hepatitis B (HepB)
1 of 3
2 months
Diphtheria, tetanus,
and pertussis (DTaP)
1 of 5
Haemophilus
influenzae type b (Hib)
1 of 4
Hepatitis B (HepB)
2 of 3
Can be given from 1 to 2 months of age
Pneumococcal (PCV)
1 of 4
Polio (IPV)
1 of 4
Rotavirus
1 of 2 or 3
4 months
DTaP
2 of 5
Haemophilus
influenzae type b (Hib)
2 of 4
Pneumococcal (PCV)
2 of 4
Polio (IPV)
2 of 4
Rotavirus
2 of 2 or 3
6 months
DTaP
3 of 5
Haemophilus
influenzae type b (Hib)
3 of 4
Hepatitis B (HepB)
3 of 3
Can be given from 6 to 18 months of age
Pneumococcal (PCV)
3 of 4
Polio (IPV)
3 of 4
Can be given from 6 to 18 months of age
Rotavirus
3 of 3, if
needed
6 months
and older
Flu (influenza)
Yearly
One dose each year. Children younger than 9
years of age may need 2 doses depending on
when they started getting this yearly
immunization.
1
Childhood Immunization Record
 1 / 4 >