Get the free VFC Vaccine Inventory Form - PHPA - ideha dhmh md

Maryland AFC Program VACCINE INVENTORY/PREFERENCE Form Fax to: (410) 333-5893 PIN (required): Facility Name: Date: / / Delivery Address (if new): Contact Name: Phone #: Fax #: Email: Special Delivery

How to fill out vfc vaccine inventory form

How to fill out VFC vaccine inventory form:

1. Begin by entering the name of the healthcare facility or clinic at the top of the form.
2. Next, provide the contact information of the facility, including the address, phone number, and email.
3. In the "Vaccine Information" section, list each vaccine separately, along with their corresponding lot numbers, expiration dates, and the number of doses received.
4. Include the total number of doses administered and the number of doses wasted in the given time period.
5. Specify the manufacturer of each vaccine and indicate if any doses were returned or transferred.
6. Sign and date the form to verify its accuracy and completeness.
7. Keep a copy of the completed form for your records.

Who needs VFC vaccine inventory form?

1. Healthcare facilities, such as hospitals, clinics, and private practices, that participate in the Vaccines for Children (VFC) program are required to maintain and submit the vaccine inventory form.
2. The VFC program is designed to provide vaccines at no cost to children who might not otherwise be vaccinated due to financial constraints. Therefore, facilities that serve eligible children aged 18 years and younger need to use the VFC vaccine inventory form.
3. By accurately completing the form, healthcare facilities ensure compliance with the VFC program's guidelines and maintain the necessary records to verify the distribution and administration of vaccines to eligible children.

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What is vfc vaccine inventory form?

The vfc vaccine inventory form is a document used to report the inventory of Vaccines for Children (VFC) program vaccines at a healthcare facility.

Who is required to file vfc vaccine inventory form?

Healthcare facilities that participate in the Vaccines for Children (VFC) program are required to file the vfc vaccine inventory form.

How to fill out vfc vaccine inventory form?

The vfc vaccine inventory form can be filled out by entering the required information about the inventory of VFC program vaccines at the healthcare facility.

What is the purpose of vfc vaccine inventory form?

The purpose of the vfc vaccine inventory form is to track and report the inventory of Vaccines for Children (VFC) program vaccines to ensure proper distribution and usage.

What information must be reported on vfc vaccine inventory form?

The vfc vaccine inventory form must include details such as vaccine type, lot numbers, expiration dates, quantities on hand, and doses administered.