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Kentucky Immunization Registry

Enrollment Forms

KYIR Enrollment Form (complete one per clinic/facility)
KYIR User Confidentiality Agreement (complete one per clinic/facility)
CHFS 219 (complete one per log-in user)

To join the Kentucky Immunization Registry, complete the enrollment forms above and fax them to the Kentucky Immunization Program. The KYIR team will contact you within 10 days with a username and password to access the registry.

Training Videos
Printable Training Material
Additional Materials for VFC


Contact Us

Phone: (502) 564-0038

Fax: (502) 564-4760



Related Content

Access to KYIR

For questions regarding meaningful use or establishing basic connectivity with your electronic medical record system, contact Kentucky Health Information Exchange


Last Updated 2/14/2017