Get the free VFC Enrollment Packet - Ohio Department of Health - odh ohio

VACCINES FOR CHILDREN PROGRAM PROVIDER AGREEMENT FACILITY INFORMATION Facilitate: FCPI#: FacilityAddress: City: Telephone: State: County: Fax: Zip: ShippingAddress(ifdifferentthanfacilityaddress):

How to fill out vfc enrollment packet

How to fill out vfc enrollment packet

1. Start by gathering all the necessary documents and information, such as the child's birth certificate, immunization records, proof of income, and proof of residency.
2. Carefully read the instructions provided in the VFC enrollment packet.
3. Complete all the required sections of the enrollment form, providing accurate and up-to-date information.
4. Ensure that all required signatures are obtained, including the parent or guardian's signature.
5. Double-check the completed enrollment packet for any errors or missing information.
6. Make copies of all the documents and keep them for your records.
7. Submit the completed VFC enrollment packet to the appropriate authority or healthcare provider, following their specific submission instructions.

Who needs vfc enrollment packet?

1. Children who are eligible for Medicaid or CHIP (Children's Health Insurance Program) may need to fill out a VFC enrollment packet.
2. Parents or guardians who want their child to receive free vaccinations through the VFC program may need to complete the enrollment packet.
3. Healthcare providers who participate in the VFC program may require their patients to fill out the enrollment packet in order to receive free vaccines.

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