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Get the free VFC KEY PRACTICE STAFF CHANGE REQUEST FORM

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Fairview System Credentialing Office CHANGE FORMReset FormTodays Date:Form Completed By:Effective Date of Change:Change Requested By:Reason for Change (Required):Practitioner Last Name:First:Middle:Title:Vital
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VFC key practice staff refers to the essential personnel involved in the Vaccines for Children (VFC) program, which provides vaccines at no cost to eligible children.
Healthcare providers participating in the VFC program are required to file information regarding their key practice staff.
VFC key practice staff can be filled out by providing the necessary information of the designated staff members involved in vaccine management and administration as specified by VFC guidelines.
The purpose of VFC key practice staff is to ensure that qualified personnel are managing and administering vaccines to eligible children under the VFC program.
Information that must be reported includes the names, titles, roles, and contact information of the key practice staff responsible for vaccine administration.
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