Forms & Statements

(For updates and information for Calworks users, please contact Heidi DeGuzman at (619) 542-4190 or email questions to: heidi.deguzman@sdcounty.ca.gov)


CAIR-SDIR Forms & Statements:
(Just updated October, 2008!)

The following forms are available to view or download. Locate the desired form and "click once" on the link to view or "right click" on the link and select "save target as" to download.

CAIR-SDIR Disclosure Statement (English)
CAIR-SDIR Disclosure Statement (en español)

CAIR-SDIR Decline to Share Form (English)
CAIR-SDIR Decline to Share Form (en español)
CAIR-SDIR-Decline to Share Form (2 sided-English/Spanish)

Have patient/parent/guardian sign, then file in patient chart.

CAIR-SDIR Application Security Acknowledgement Form
(replaces CAIR-SDIR User Confidentiality Oath Form)

Keep Your Immunization Records Online!
Download, complete, and fax us this form.


CAIR-SDIR Request for CIR (English)
CAIR-SDIR Request for CIR (en español)
CAIR-SDIR Request for CIR (2-sided English/Spanish)
Use this for requesting a copy of you or your child's CA Immunization Record.


Change-IZ-Type-or-Date-Request-Form.pdf
Use this form for requesting changes to immunization data.

"If You Have a Bug" Use this form to report application "bugs".

User Suggestion Form
Use this form to give us your suggestions.

SDIR Materials Order Form
Use this form to order all your SDIR materials, then return form via fax or email as instructed on form. To download, select appropriate format below, "right click" on the link and select "save target as", select a location on your local PC to save a copy.

How are we doing?
If you have recently received service from any of our Registry staff, you are invited to download and complete our Customer Satisfaction Form and fax it to our Customer Service Manager at (619) 692-6619.

Click on the link below to return to the SDIR login page:

http://www.sdirprod.org

or

http://www.sdir.org

Many of the downloadable documents on this site may be viewed or printed using Adobe® Acrobat® software. Click on the icon below to download Acrobat® Reader® directly from http://www.adobe.com.