Posted: Wed, 03/14/2012 - 2:21pm Updated: Mon, 04/05/2021 - 9:00am

CHIRP Permission form

To utilize the Children and Hoosiers Immunization Registry Program (CHIRP), active parent permission is required for school nurses to submit immunization records into the registry to comply with the Family Educational Rights and Privacy Act (FERPA). Sample forms are posted on this page for schools to use to obtain parent permission. A signature from a parent is only required one time. For more information about CHIRP, go to at the Indiana State Department of Health.