How to obtain a Shot History 

To request a copy of a history of immunizations given at ECHD, please print the following Adobe pdf application form: Click Here

Click here to view the ECHD Notice of Privacy Practices.

Please note:  Due to the requirement to have a signature on this form, please print the form from the above link, complete and sign it, then either fax to ECHD at 440-284-1558 or mail to:

ECHD

202 Chestnut St.

Elyria, Ohio 44035