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Fellow Missoulians—help us conserve PPE while preventing the spread of COVID-19. When visiting our clinic, please wear a cloth face covering, or as we like to call it—community protective equipment.

For more info, Click on the hyperlink: Use of Cloth Face Coverings to Help Slow the Spread of COVID-19

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Immunizations are available by appointment only

  Same day appointments are available

Monday through Friday 9 - 5 pm

Closed during the lunch hour from 12 - 1 pm

Forms

The following forms are recommended to be completed before coming in for vaccination. 

COVID-19 Vaccine Screening Checklist

Vaccine Screening Checklist

Release of Information

Demographic Information

If the child is an unaccompanied minor (above the age of 15) or being accompanied by someone other than a legal guardian (third party), these forms are required to be filled out completely and signed.

Third Party Authorization Packet - This is for a parent/legal guardian authorizing another adult to bring their child to the clinic.

 Unaccompanied Minor Packet - This is for a parent/legal guardian to give authorization for their 15 - 17 year old adolescent to receive services at the clinic without an adult present.

 

What to Bring to Your Appointment

  • Records - Unless the Health Department is your child's usual provider of vaccinations, you must either bring the vaccination records with you or have them faxed to (406) 258-4913.

  • Insurance Card - Call your insurance provider in advance to make sure they cover vaccines provided at the Missoula City-County Health Department.  Dependent on family income, children who do not have insurance or have high deductibles may be charged at a lower rate or no cost.

  • Photo ID - Acceptable forms of ID:  current drivers license, state ID card, or passport.  (parent or legal guardian)


Vaccine Record Information

  • Consenting adult or Parent/Legal Guardian may complete the following Release of Information to have MCCHD release records from our clinic or the State registry (imMTrax).  Include a copy of a valid photo ID. 

  • Please fax the Release of Information authorization to the Health Department at (406) 258-4913.  Please allow up to 3 business days for MCCHD to release records. 

  • Records on file are either faxed or mailed.  Record pick-up is unavailable at this time.


For more information, please call us at (406) 258-4745. We are happy to help.