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Become an Authorized Yellow Fever Vaccine Provider

Information for Travelers

Information for Providers

An International Travel Clinic provides pre-travel individualized risk assessments and education about health concerns to patients, and provides necessary prophylaxis and vaccinations (including yellow fever vaccine) as recommended or required for travel abroad.

How to Become an International Travel Clinic in the State of Indiana

Many countries require specific travel immunizations for visitors.  International health regulations require that yellow fever vaccine be administered only at designated yellow fever vaccination centers.  In the United States the responsibility for designating yellow fever vaccination centers has been delegated to state health departments.

In Indiana, health care providers who wish to become International Travel Clinics and administer yellow fever vaccine must apply and be approved by the Indiana State Department of Health (ISDH).  Any physician (M.D. or D.O.) licensed in Indiana is eligible to become a certified yellow fever provider.

  • Application Process:

1. Review the Yellow Fever Vaccine Certified Provider Application and verify that you meet the requirements to become a certified yellow fever vaccine provider.

2. Order your Uniform Stamp.  Uniform stamps can be ordered at a local stationary or office supply store.  Physicians will use their Indiana medical license number for the third line of the uniform stamp, while local health departments will use county and city codes.

3. Submit the completed application form (including imprint of the Uniform Stamp) to the ISDH:

        • Scan and e-mail to the International Travel Clinic contact person; OR
        • Fax to 317-234-2812

4. Upon receipt of your application, ISDH staff will verify that all information is complete and accurate.  Your approval to administer yellow fever vaccine will be submitted to Sanofi Pasteur (manufacturer of yellow fever vaccine).  Orders for vaccine are placed by the provider directly through the manufacturer.  Note that yellow fever vaccine is shipped only to the provider and to the address indicated on the Yellow Fever Vaccine Certified Provider Application.

5. An annual reporting of vaccination and clinic activity will be requested by the ISDH International Travel Clinic program.

6. Using the appropriate form provided below, please notify the ISDH Travel Clinic program is there are any changes in the information (e.g. address, phone number, contact information, physician) included on your application.

Yellow Fever Vaccine Provider Forms:

Yellow Fever Vaccine Certified Provider Application Form

Yellow Fever Vaccine Certified Provider Change of Address Form

Yellow Fever Vaccine Certified Provider Withdrawal Form

Format of Yellow Fever Uniform Stamp

City and County Codes for Use by Local Health Departments Only

Information and Resources for Travel Health Care Professionals

  • Health Professionals Education:

- CDC Travelers' Health Medscape Video Blogs for Clinicians

- CDC Travelers' Health CE Courses and Training (Courses covering various diseases including "Yellow Fever Vaccine: Information for Health Care Professional Advising Travelers

  • International Health Regulations:

- World Health Organization (WHO)

- International Certificate of Vaccination or Prophylaxis Booklet (WHO)

  • To comply with the International Health Regulations (2005), the CDC revised the International Certificate of Vaccination or Prophylaxis (ICVPs) in 2007.
  • Currently, yellow fever is the only disease under the International Health Regulations (2005) for which proof of vaccination may be required for travelers.  Previously issued certificates remain acceptable proof of vaccination against yellow fever as long as the certificate is valid.  The certificate of vaccination is valid for a period of 10 years, beginning 10 days after the date of vaccination.  When a booster dose of the vaccine is given within this 10-year period, the certificate is considered valid from the date of revaccination.  Travelers should keep the ICVP with their passports at all times.
  • - Government Printing Office Bookstore (purchase ICVPs Cards)

    Additional Travel Website Resources

    U.S. Department of State

    U.S. Citizenship and Immigration Services

    Immunization Action Coalition: International Travel Vaccinations

    The American Society of Tropical Medicine and Hygiene

    International Society of Travel Medicine

    Contact Us

    For more information on international travel, contact:

    Deborah Ilufoye