Record Release

Immunization Request

The Health and Insurance Services Office maintains your immunization records for 7 years after your date of admission to the College.

To request a copy of your records, please complete the Record Release Form. This information will only be used to identify your records and to send them wherever you designate.


The acronym HIPAA stands for the Health Insurance Portability and Accountability Act. This US law is designed to provide privacy standards to protect patients' medical records and other health information provided to health care professionals, hospitals, and parents or guardians of adults over the age of 18.

If you would like us to intervene on your behalf with these parties, the Disclosure Form authorizes us to communicate medical information to those whom you designate. This authorization will become effective at signing and shall remain in effect as long as the individual is a student at Daemen College. If the student wishes to revoke this authorization, the request can be submitted at any time to the Health and Insurance Services office.