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NEW YORK STATE BUREAU OF IMMUNIZATION VACCINES FOR CHILDREN (AFC) AND CHILD HEALTH PLUS (PLUS) PROGRAMS MONTHLY DOSES ADMINISTERED REPORT (FOR PRIVATE PROVIDERS ONLY) Provider Name: AFC PIN #: Address:

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What is monthly doses administered report?

The monthly doses administered report is a report that provides information on the number of doses of a medication or vaccine administered within a specific month.

Who is required to file monthly doses administered report?

The healthcare providers or organizations, such as hospitals or clinics, that administer medications or vaccines are required to file the monthly doses administered report.

How to fill out monthly doses administered report?

The monthly doses administered report can be filled out by entering the required information, such as the type of medication or vaccine administered and the number of doses, into the designated fields of the reporting form.

What is the purpose of monthly doses administered report?

The purpose of the monthly doses administered report is to track and monitor the administration of medications or vaccines, allowing for analysis of healthcare trends and ensuring compliance with regulatory requirements.

What information must be reported on monthly doses administered report?

The monthly doses administered report must include information such as the type of medication or vaccine administered, the number of doses administered, the date of administration, and the patient demographic information (such as age and gender).

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