Vol. 35 Iss. 20 - May 27, 2019

Chapter 115

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 12VAC5-115. Virginia Immunization Information System.

Contact Information: Kristin Collins, Policy Analyst, Office of Epidemiology, Virginia Department of Health, 109 Governor Street, Office 642, Richmond, VA 23219-3623, telephone (804) 864-7298, or email

FORMS (12VAC5-115)

Administrator Information, VIISADM (eff. 10/2012)

Electronic Data Exchange with VIIS (eff. 10/2012)

Information Systems Security Access Agreement (eff. 10/2012)

Organization Information, VIISORG (eff. 10/2012)

VIIS Security Policy and User Confidentiality Agreement

Memorandum of Agreement between Virginia Department of Health/Division of Immunization (VDH/DOI) and VIIS Organization Interested in Data Exchange (8/2011)

Virginia Immunization Information System (VIIS) Opt-In of VIIS (reviewed 6/2015)

Virginia Immunization Information System (VIIS) Opt-Out of VIIS (reviewed 6/2015)

VIIS Security Policy and User Confidentiality Agreement (rev. 5/2019)

VIIS User Acknowledgement Page

VIIS User Signature Page

VA.R. Doc. No. R19-5998; Filed May 10, 2019, 4:01 p.m.