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Immunization Record Request Form

Fargo Cass Public Health (FCPH) is pleased to offer the Immunization Record Request Form for your convenience. Contact the FCPH Immunization Program at 701.241.1383 (select option 2 when prompted) with any questions.

Routine Immunizations for K-12 Students

Parents are encouraged to contact their child's healthcare provider to make sure immunizations are up-to-date for school entry in the fall.


Fargo Cass Public Health offers the following immunizations:

  • Hepatitis A
  • Hepatitis B
  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Chicken pox
  • Rotovirus
  • Pneumovax
  • Meningococcal
  • Meningococcal B (Bexsero)
  • HPV-9 (human papillomavirus vaccine, 9-valent)
  • Shingles
  • Hib (for children only)
  • PPSV23 (pneumococcal polysaccharide vaccine)
  • PCV13 (pneumococcal conjugate vaccine)
  • COVID-19
    • Pfizer vaccine for 12 years and older
      * Two-dose series with doses 21 days apart
    • Moderna vaccine for 18 years and older
      * Two-dose series with doses 28 days apart
  • Flu (seasonal)

Immunization Schedules

Personalize your child's immunization schedule Ages 0-6

Immunization Schedule Ages 7-18

Adult Immunization Schedule

Required Immunizations

North Dakota law states that a child may not be admitted to any public or private school, day care, Head Start program or preschool unless the child’s parent or guardian shows proof that the child has received the required immunizations. If your child has immunization exemptions, please submit an exemption form.

We offer the Vaccine for Children (VFC) program. Those children who qualify for VFC must be 18 years of age or younger and Native American, Medicaid eligible or uninsured

Vaccination Forms

The first two forms below can be printed prior to arriving to FCPH to receive an influenza vaccination:

Influenza Consent & HIPAA, Billing 2020

Influenza - What you need to know (Centers for Disease Control and Prevention)

Notice of Privacy Practices 2020


To schedule an appointment or for information on vaccine pricing, call 701.241.1383 (select option 2 when prompted). For immunization questions, call 701.241.8189.