School Survey Packet - Alabama Department of Public Health
October 1, 2023
Subject: 2023-2024 Immunization School Entry Survey
Dear Principal or Headmaster:
The Alabama Department of Public Health (ADPH), Immunization Division, annually surveys all public and private schools to ensure all students are compliant with the Alabama School Immunization Law ? 16-30-4; . All public and private students are required to have an up-to-date ADPH-approved Certificate of Immunization (COI) printed from Immunization Patient Resources with Integrated Technology (ImmPRINT).
School-required vaccines prevent the following diseases: diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, and varicella. This survey identifies students who need additional vaccines, or documentation of vaccines, and to assist schools in their effort to comply with statutory requirements.
Please login to ImmPRINT and run the CDC COI Action report to ensure the information in ImmPRINT is correct before the survey due date. If your school is enrolled in ImmPRINT and all students are assigned, either manually or automatically via ALSDE file, there is no requirement to complete the survey. For those schools who are not enrolled in ImmPRINT, please go to the following link to enroll: Initial Site Enrollment Agreement
Your site will go through an approval process, and you will be contacted by an Immunization Compliance Team Member from our field staff. This Immunization School Entry Survey should be completed by December 15, 2023.
If you have any questions about the immunization requirements, and/or ImmPRINT, please contact your Immunization Compliance Team Member on the List enclosed. For your convenience, we have enclosed the instructions to complete the Immunization School Survey through ImmPRINT and a sample parent letter.
Thank you for your assistance in completing Alabama's 2023-2024 Immunization School Entry Survey.
Sincerely,
Denise Strickland
Director, Immunization Division DS/FZ
Sample Parent Letter Dear Parent or Guardian:
The State of Alabama School Law, ?16-30-4, requires all students entering public or private school to present an up-to-date Alabama Certificate of Immunization (COI), an Alabama Certificate of Religious Exemption, or an Alabama Certificate of Medical Exemption for specific vaccine preventable diseases.
While conducting the annual School Entry Survey, it was discovered that your child lacked the item(s) marked below. Please bring documentation of updated immunization history.
If you have any questions or need additional information concerning required vaccines or certificates, please call your physician or county health department.
Thank you for your cooperation.
Sincerely,
Your child needs:
Principal or Headmaster Signature
-------------Alabama Certificate of Immunization
-------------Documentation of varicella vaccine
-------------Documentation of tetanus/diphtheria/acellular pertussis vaccine
-------------Documentation of polio vaccine received on or after the 4th birthday
-------------Documentation of MMR vaccine
Carta de muestra para padres
Estimados padres o tutores:
La Ley Escolar del Estado de Alabama, ?16-30-4, requiere que todos los estudiantes que ingresan a una escuela p?blica o privada presenten un Certificado de Vacunaci?n (Certificate of Immunization, COI) de Alabama actualizado, un Certificado de Exenci?n M?dica de Alabama o un Certificado de Exenci?n religiosa.
Mientras se realizaba la Encuesta de Ingreso a la Escuela anual, se descubri? que a su hijo(a) le faltaban las vacunas marcadas a continuaci?n. Vaya al proveedor de su hijo(a) para recibir la vacuna y traiga documentaci?n del historial de vacunaci?n actualizado.
Si tiene alguna pregunta o necesita informaci?n adicional sobre las vacunas o certificados requeridos, llame a su m?dico o al departamento de salud del condado.
Gracias por cumplir con las leyes y normas estatales de inmunizaci?n.
Atentamente,
Su hijo(a) necesita:
Firma del Director
-----------Certificado de inmunizaci?n de Alabama
------------Documentaci?n de la vacuna contra la varicela (VAR)
------------Documentaci?n de la vacuna contra el t?tanos/difteria/tos ferina acelular (Tdap)
------------Documentaci?n de la vacuna contra la poliomielitis (IPV) recibida al cumplir 4 a?os de
edad o despu?s
------------Documentaci?n de la vacuna contra el sarampi?n, las paperas y la rub?ola (Measles, Mumps, and Rubella, MMR)
Instructions for Completing the 2023-2024 School Entry Immunization Survey through ImmPRINT
Immunization Patient Registry with Integrated Technology (ImmPRINT) is a statewide population-based information system for all children and adults born in Alabama since January 1, 1993. We are encouraging enrollment to ImmPRINT for all schools, both public and private, within the state of Alabama. There are many benefits to enrolling in ImmPRINT. These benefits include printing only ADPH approved Certificate of Immunizations, using the Vaccine Forecaster to ensure the best medical decision for vaccinations, running Vaccine Coverage Rate Reports for your school, and increasing the overall health of your school community by increasing vaccination rates among students.
Please visit our webpage at the following link for additional information: . Once you have reviewed the webpage, please enroll online so that you can become a part of increasing vaccination rates for your school. We have District staff members that will train you and answer your questions when needed.
To enroll in ImmPRINT, please go online: . Complete the Initial Site Enrollment Agreement. Immunization staff will review, verify, and approve your agreement. Your site will be contacted by Immunization Division (IMM) Field Compliance Staff to conduct ImmPRINT training for your school. If you have any questions, please send an email to: immprint@adph.state.al.us.
Enroll in ImmPRINT online at
Please follow these instructions to complete the online survey form:
1. Log in to ImmPRINT 2. Click the Immunization Registry 3. Go to Reports 4. Click on CDC Survey 5. Select your school 6. Run your report
If your school is enrolled in ImmPRINT, please verify your students are assigned to your school. All public and private students are required to have an up-to-date ADPH-approved Certificate of Immunization (COI) printed from Immunization Patient Resources with Integrated Technology (ImmPRINT).
If you have any questions about the immunization requirements, and/or ImmPRINT, please contact your Immunization Compliance Manager (ICM) or Team Member List enclosed. For your convenience, we have enclosed the instructions to complete the Immunization through ImmPRINT.
County Autauga Baldwin Barbour Bibb Blount Bullock Butler Calhoun Chambers Cherokee Chilton Choctaw Clarke Clay Cleburne Coffee Colbert Conecuh Coosa Covington Crenshaw Cullman Dale Dallas DeKalb Elmore Escambia Etowah Fayette Franklin Geneva Greene Hale Henry Houston
ICM and Team Contact Information
Primary Contact
Linnie Mosley
Angela "Tina" Lassiter Mary "Liz" Thrash Sharon Bradford Sarah Isaac
Linnie Mosley
Mary "Liz" Thrash
Paula Hopper
Linnie Mosley Kelly Clayton Sharon Bradford Catherine Diggs Catherine Diggs Kelly Clayton
Kelly Clayton Mary "Liz" Thrash
Tonea Santos Tina Lassiter Linnie Mosley
Mary "Liz" Thrash Tammy Brown Ronnie Darrington Mary "Liz" Thrash Catherine Diggs Kelly Clayton Linnie Mosley
Tina Lassiter
Sarah Isaac Frankie Kimbrell
Ronnie Darrington
Tammy Brown Sharon Bradford Sharon Bradford Tammy Brown Tammy Brown
Phone Number Cell Number Email Address
334-206-7026 334-462-4357 linnie.mosley@adph.state.al.us
251-847-6834 251-223-1943 angela.lassiter@adph.state.al.us 334-393-5548 256-565-9271 mary.thrash@adph.state.al.us 205-562-6982 251-593-9524 sharon.bradford@adph.state.al.us 334-445-5156 334-318-2913 sarah.isaac@adph.state.al.us
334-206-7026 334-462-4357 linnie.mosley@adph.state.al.us
334-393-5548 256-565-9271 mary.thrash@adph.state.al.us
256-240-7858 256-300-0055 paula.hopper@adph.state.al.us
334-206-7026 334-462-4357 linnie.mosley@adph.state.al.us 256-845-8754 256-254-0173 kelly.clayton@adph.state.al.us 205-562-6982 251-593-9524 sharon.bradford@adph.state.al.us 334-877-2878 334-530-2050 catherine.diggs@adph.state.al.us 334-877-2878 334-530-2050 catherine.diggs@adph.state.al.us
256-845-8754 256-254-0173 kelly.clayton@adph.state.al.us
256-845-8754 256-254-0173 kelly.clayton@adph.state.al.us 334-393-5548 256-565-9271 mary.thrash@adph.state.al.us
256-771-6020 256-565-6330 tonea.santos@adph.state.al.us
251-847-6834 251-223-1943 angela.lassiter@adph.state.al.us
334-206-7026 256-462-4357 linnie.mosley@adph.state.al.us
334-393-5548 256-565-9271 mary.thrash@adph.state.al.us 334-684-2256 334-320-0628 tammy.brown@adph.state.al.us 256-533-8766 256-202-7041 ronnie.darringon@adph.state.al.us 334-393-5548 256-565-9271 mary.thrash@adph.state.al.us 334-877-2878 334-530-2050 catherine.diggs@adph.state.al.us 256-845-8754 256-254-0173 kelly.clayton@adph.state.al.us 334-206-7026 334-462-4357 linnie.mosley@adph.state.al.us 251-847-6834 251-223-1943 angela.lassiter@adph.state.al.us 334-445-5156 334-318-2913 sarah.isaac@adph.state.al.us 205-295-4750 205-388-2595 frankie.kimbrell@adph.state.al.us 256-533-8766 256-202-7741 ronnie.darrington@adph.state.al.us 334-684-2256 334-320-0628 tammy.brown@adph.state.al.us 205-562-6982 251-593-9524 sharon.bradford@adph.state.al.us 205-562-6982 251-593-9524 sharon.bradford@adph.state.al.us 334-684-2256 334-320-0628 tammy.brown@adph.state.al.us 334-684-2256 334-320-0628 tammy.brown@adph.state.al.us
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