Get the free VFC

Division of Public Health Services Immunization Program Office Public Health Preparedness Services 150 N. 18th Avenue, Suite 120 Phoenix, Arizona 85007 (602) 3643630 (602) 3643285 FAX www.azdhs.gov

How to fill out vfc

How to Fill Out VFC:

Gather Required Information:

1. Obtain the application form for the Vaccines for Children (VFC) program.
2. Collect necessary information about the child, such as their full name, date of birth, and address.
3. Determine the child's eligibility for VFC based on specific criteria, such as age, insurance status, and vaccine requirements.

Complete Personal Information:

1. Fill out the child's personal details accurately on the VFC application form.
2. Provide the child's complete name, date of birth, gender, and contact information.
3. Include the parent or guardian's name, contact number, and relationship to the child.

Select Vaccines Needed:

1. Review the list of vaccines offered through the VFC program and determine which vaccines are required for the child based on their age and immunization status.
2. Mark the checkboxes or indicate the vaccines needed on the application form.

Verify Eligibility:

1. Check the child's eligibility for VFC based on factors like income level, Medicaid enrollment, or being uninsured.
2. Provide necessary documents, if required, to validate the child's eligibility (e.g., proof of income, Medicaid card, insurance information).

Acknowledge Responsibility:

1. Sign and date the VFC application form as the responsible parent or guardian.
2. By signing the form, you acknowledge that all the information provided is accurate to the best of your knowledge.

Who Needs VFC:

Uninsured Children:

1. VFC primarily benefits children who are uninsured, underinsured, or have Medicaid coverage without vaccine benefits.
2. If a child does not have health insurance coverage that includes vaccines, they are generally eligible for VFC.

Medicaid-Enrolled Children:

1. Children enrolled in the Medicaid program can receive vaccines through VFC if their Medicaid coverage does not include vaccines.
2. VFC ensures access to necessary immunizations for children even if their insurance does not cover vaccines.

American Indian or Alaska Native Children:

VFC also provides vaccines to American Indian or Alaska Native children who are eligible for the Indian Health Service or tribal health programs.

In summary, filling out the VFC involves gathering necessary information, completing personal details and vaccine selection on the application form, verifying eligibility based on various criteria, and acknowledging responsibility through signature. The VFC primarily targets uninsured children, those with limited insurance coverage, Medicaid-enrolled children without vaccine benefits, and American Indian or Alaska Native children eligible for specific programs.

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What is vfc?

VFC stands for Vaccines for Children program, a federal program that provides vaccines at no cost to children who might not otherwise be vaccinated because of the inability to pay.

Who is required to file vfc?

Health care providers who administer vaccines to children that are eligible for the Vaccines for Children program are required to file VFC.

How to fill out vfc?

To fill out VFC, health care providers need to follow the guidelines set by the Centers for Disease Control and Prevention (CDC) and the Vaccines for Children program.

What is the purpose of vfc?

The purpose of VFC is to ensure that all children have access to vaccines, regardless of their ability to pay, in order to maintain high immunization coverage rates and prevent the spread of vaccine-preventable diseases.

What information must be reported on vfc?

Health care providers must report information such as the doses administered, patient demographics, and vaccine inventory management to the Vaccines for Children program.