Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Montana Department of Public Health and Human Services – Immunization Program. Before sending anything sensitive, confirm the number and receiving department directly with Montana Department of Public Health and Human Services – Immunization Program, and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.

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Montana Department of Public Health and Human Services – Immunization Program fax number

(406) 444-2920

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Montana DPHHS Immunization Program (imMTrax)

Used for: Submitting immunization record requests and releasing records through Montana's Immunization Information System (imMTrax).

Fax destination details

Department
Montana DPHHS Immunization Program (imMTrax)
Purpose
Submitting immunization record requests and releasing records through Montana's Immunization Information System (imMTrax).
Form
Montana Immunization Information System Authorization to Release Immunization Records (imMTrax) — Montana Immunization Information System Authorization to Release Immunization Records
Address
Montana Department of Public Health and Human Services – Immunization Program, P.O. Box 202951, Helena, MT 59620-2951
Voice phone
406-444-5580

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Complete patient information and receiving organization details; specify the official recipient and reason for request; fax to (406) 444-2920; allow 3 business days for processing; must be signed and dated.

Official form instructions are published as a downloadable file on the organization's website.

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