"I understand that this withdrawal from participation in the registry will not prevent me or my child from receiving immunizations/vaccinations.
I understand withdrawing will delete all existing vaccine information within the NHIIS for myself or for my child. This is a permanent deletion that cannot be undone.
I understand that I may reverse my decision by completing a "Reverse Previous Decision not to Participate in the New Hampshire Immunization/Vaccination Registry" (3/2016) form with my current healthcare provider.
I understand that it is my responsibility to inform my other health care providers of my decision to withdraw from the registry so that no future immunization/vaccination information is reported to the NHIIS.
Patients who choose to withdraw from participation in the registry are not relieved from the obligation to comply with current immunization requirements set forth in RSA 141-C:20-a and He-P 301.14."4;
N.H. Admin. Code § He-P 307.07
#6830, INTERIM, eff 8-14-98, EXPIRED: 12-12-98
New. #6941, eff 1-30-99