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Immunization Record Request

Information Needed for Immunization Record Request

  • First name, middle name or initial, current last name, maiden name
  • Your address, including street, city, state and zip code
  • Date of birth
  • Year of graduation or date of withdrawal from school
  • A phone number where you may be reached, including area code
  • Name, email or address of the college/university or employer & company requesting a copy of your immunization record

Immunization Record Request 


Fax: (315) 434-3020

Mail:  East Syracuse Minoa Central School District
          Attn:  Immunization Record Request
          407 Fremont Road                                        
          East Syracuse, New York  13057

Telephone: (315) 434-3012 if you have additional questions.