Get the free Fax this form to the VFC Program 410 333-5893 VACCINE ... - PHPA

Maryland Vaccines For Children Program 2011-2012 Influenza Vaccine Inventory/Order Form Date: / / PIN (required): Facility Name: Delivery Address (if new): Contact Name: Phone #: Email: Fax #: Special

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1. Start by reviewing the form carefully. Read all instructions and requirements to ensure you provide accurate information.
2. Gather all the necessary documents and information required to complete the form. This may include personal identification, contact details, or any supporting documents needed.
3. Using a pen or a typewriter, fill in the required fields on the form. Make sure your handwriting is clear and legible if you choose to write it manually.
4. Pay attention to any specific formatting or organization requirements. Some forms may have designated sections for certain information, so make sure to follow those guidelines.
5. Double-check your entries for any errors or mistakes. It is essential to ensure that all the information provided is accurate and up-to-date.
6. If any sections or fields are not applicable to your situation, mark them as "N/A" or "Not Applicable" to avoid any confusion.
7. Once you have completed the form, gather any supporting documents and make copies if necessary. Ensure that all supporting documents are organized and attached securely to the form.
8. Locate a fax machine or use an online fax service. If using a fax machine, follow the instructions provided by the machine to send the form. If using an online fax service, upload the form and follow the website's prompts to send it.

Who needs to fax this form?

1. The specific recipient or organization to which you need to send the form will be mentioned in the instructions or guidelines provided. Review the form or any accompanying paperwork to identify the appropriate recipient.
2. In some cases, the form may need to be faxed to a government agency, employer, educational institution, or any other authorized entity. Ensure you have the correct fax number or contact information for the recipient.
3. If unsure about the intended recipient, consider reaching out to the organization or individual who provided you with the form. They will be able to provide clarity on where the form needs to be sent.

Remember, it is crucial to keep a copy of the faxed form and supporting documents for your records. Additionally, it is advisable to follow up with the recipient to confirm the successful delivery of the faxed form.

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Fax this form to the designated fax number provided on the form.

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