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DEPARTMENT OF HEALTH SERVICES Division of Public Health F02329 (05/2018)STATE OF WISCONSIN Vaccine for Children (AFC) Program CHANGE OF INFORMATION Instructions: Facilities are required to notify
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How to fill out vfc change of information

01
To fill out VFC change of information form, follow these steps:
02
Start by downloading the VFC change of information form from the official website.
03
Read the instructions carefully before proceeding.
04
Begin by providing your personal details such as your name, address, and contact information.
05
Fill in the sections pertaining to the changes you want to make. This may include updating your healthcare provider information, changing your clinic address, or modifying your contact person details.
06
Double-check all the information you have entered to ensure accuracy and completeness.
07
If there are any supporting documents required, make sure to attach them along with the form.
08
Once you have filled out all the necessary sections, sign the form.
09
Submit the completed form and any supporting documents through the designated channels, which may include mailing or faxing it to the appropriate VFC program office.
10
Keep a copy of the filled-out form for your records.
11
Wait for confirmation or further instructions from the VFC program office regarding the changes you have requested.

Who needs vfc change of information?

01
The VFC change of information form is needed by individuals or entities enrolled in the Vaccines for Children (VFC) program who wish to update their existing information. This may include healthcare providers, clinics, or organizations participating in the VFC program.
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VFC change of information is a form that allows individuals or organizations to update their information with the Vaccine For Children program.
Any individual or organization participating in the Vaccine For Children program is required to file vfc change of information when there are changes to their information.
You can fill out vfc change of information either online through the VFC website or by submitting a paper form via mail.
The purpose of vfc change of information is to ensure that the Vaccine For Children program has up-to-date and accurate information for all participants.
Typically, vfc change of information requires reporting of basic information such as contact details, healthcare provider information, and vaccine inventory.
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