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This document provides detailed instructions for healthcare providers on how to complete and submit the VFC Vaccine Order Form to ensure timely processing of vaccine orders.

How to fill out vfc vaccine order form

How to fill out VFC Vaccine Order Form

1. Start by downloading the VFC Vaccine Order Form from the official website.
2. Fill out the provider information section with your name, address, and contact details.
3. Indicate the facility type and the VFC provider number if applicable.
4. Specify the vaccines needed by entering the vaccine names and quantities in the appropriate boxes.
5. Check the inventory balance to ensure accurate ordering.
6. Include any additional notes or special instructions if necessary.
7. Review the completed form for accuracy before submission.
8. Submit the order as instructed on the form, typically via fax or email to the designated health department.

Who needs VFC Vaccine Order Form?

1. Healthcare providers who are part of the Vaccines for Children (VFC) program.
2. Clinics and practices that provide vaccines to eligible children.
3. Organizations that require additional vaccine supplies for administering immunizations.

People Also Ask about

How to code for VFC vaccines?

The administration fee for the VFC Measles, Mumps, Rubella and Varicella (MMRV) vaccine is billed with CPT code 90710 and modifier SL for children 12 months through 12 years of age (before the 13th birthday) who need a first or second dose of MMR and varicella vaccine.

What details must be documented when a vaccination is given?

The date the VIS is provided (i.e., the date of the visit when the vaccine is administered). The office address and name and title of the person who administers the vaccine. The date the vaccine is administered. The vaccine manufacturer and lot number.

What are the requirements for VFC vaccine documentation?

In ance with federal law, VFC providers must maintain immunization records that include ALL of the following elements: (1) name of vaccine administered; (2) date vaccine was administered; (3) date VIS was given; (4) publication date of VIS; (5) name of vaccine manufacturer; (6) vaccine lot number; (7) name and

When should screening and documentation of VFC eligibility be conducted?

VFC eligibility screening and documentation of eligibility status must take place with each immunization visit to ensure the child's eligibility status has not changed. While verification of responses is not required, it is necessary to retain this or a similar record for each child receiving vaccine.

What are considered VFC program records?

VFC records include, but are not limited to, VFC screening and eligibility documentation, billing records, medical records that verify receipt of vaccine, vaccine ordering records, and vaccine purchase and accountability records.

Do you need a doctor's order to get a vaccine?

Getting a vaccine at a doctor's office or health department does not require a patient-specific prescription from another health care provider.

What vaccines are VFC?

Which Vaccines are Provided? Diphtheria. Haemophilus influenzae type b (Hib) Hepatitis A. Hepatitis B. Human Papillomavirus (HPV) Influenza (flu) Measles. Meningococcal disease.

For pdfFiller’s FAQs

What is VFC Vaccine Order Form?

The VFC Vaccine Order Form is a document used by healthcare providers to request vaccines from the Vaccines for Children (VFC) Program, which provides vaccines at no cost to eligible children.

Who is required to file VFC Vaccine Order Form?

Healthcare providers who participate in the VFC program and need to order vaccines for eligible children are required to file the VFC Vaccine Order Form.

How to fill out VFC Vaccine Order Form?

To fill out the VFC Vaccine Order Form, providers must provide specific information such as their practice details, the types and quantities of vaccines being requested, and verify their eligibility and compliance with VFC requirements.

What is the purpose of VFC Vaccine Order Form?

The purpose of the VFC Vaccine Order Form is to facilitate the ordering process of vaccines for eligible children, ensuring that providers can obtain necessary vaccines for their patients efficiently.

What information must be reported on VFC Vaccine Order Form?

The information that must be reported includes the healthcare provider's details, a list of requested vaccines, corresponding quantities, and compliance statements regarding VFC program standards.