If you’re new to Connecticut or previously opted out of the Immunization Information System (CT WiZ), you can enroll yourself or your child (under age 18) into CT WiZ.
Below are options on how you can enroll in CT WiZ:
Complete this secure online form
Provide your contact information and select “Other/Unsure.” In the “Please provide details” box, type that you want to enroll in CT WiZ and complete the contact information for yourself or your child (under age 18). You'll need to provide proof of identification and the name and town of the doctor for the person you are enrolling.
By Mail or Fax:
You can print and complete the English CT WiZ enrollment form or the Spanish CT WiZ enrollment form. Or you can send us a letter that includes the following information for yourself or your child (under age 18) you are enrolling:
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First and last name
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Date of birth
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Address (street address, city, state, zip code)
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Phone number
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Email
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Name and town of the doctor for the person you are enrolling
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Copy of your proof of identification
Mail: CT Department of Public Health, CT WiZ
410 Capitol Avenue, MS # 11 MUN
Hartford, CT 06134-0308
Fax: 860-707-1925
Call: 860-509-7929
You can call the DPH Immunization Program to request to enroll. You'll need to provide proof of identification by mail, fax, or the secure online form.
We do NOT accept email, as routine email messages are not a secure way to send patient information.
DPH will enroll you or your child in CT WiZ as soon as possible. Then you can view, download, or print your immunization record. Visit CT WiZ: Access My Immunization Record to learn how to view your vaccination record securely online or request a copy.