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To
get your program enrolled, you must send:
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Two
(2) copies of the CHILD
Profile Information Sharing Agreement (.pdf)
signed by your Program Grantee's authorized signator. |
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For
clarification, please call Pamela Johnson at 360-236-3551. |
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One
(1) copy of the CHILD
Profile Immunization Registry Head Start/ECEAP
Account Application (.pdf) |
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Note:
Please identify a technical lead or contact person at
your Program Administrative Office. Submit the contact
information for that technical staff member on the Account
Application.
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Please
mail all copies to:
CHILD Profile Immunization
Registry
401 Fifth Avenue, Suite 1000
Seattle, WA 98104 |
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You
must have
Adobe Acrobat Reader 6.0 or above installed on your
computer to read the (.pdf) files above. Click to
Download
Acrobat Reader for free. |
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Questions?
Call 1-800-325-5599 or go to the Frequently
Asked Questions page. |
