VFC Enrollment & Recertification
- Enrollment instructions and online forms
- Key Practice Staff Change Request form
- Recertification is required annually. Access the on-line form from your MyVFCvaccines account. Utilize the Recertification Worksheet to help gather this information ahead of time.
- Patient Eligibility Screening Record for VFC
- Patient Eligibility Screening Record (Spanish)
Use this form to document the eligibility status of the patient.
- VFC Eligibility Screening and Documentation Requirements
- Vaccine Management Plan – word template | pdf
- VFC Vaccine Physical Inventory Form
- Daily Usage Logs: | VFC Vaccine | Private | 2015-2016 Flu
- Return/Transfer of VFC Vaccine
- Refrigerator Temperature Logs Fahrenheit | Celsius
- Freezer Temperature Logs Fahrenheit | Celsius
- Vaccine Receiving Log and Checklist
- Frozen Vaccine Transport Log
- Refrigerated Vaccine Transport Log
Documentation of Tdap Administration
- Tdap Screening Form
- Tdap? DTap? Td? Clinicians: Keep it Clear for Schools
- Is it Tdap or DTap? job aid
- Legal Requirements for Reporting Diseases
Reportable diseases and conditions, Title 17, California Code of Regulations.
- Communicable Disease Control Forms
A collection of forms to be used to report diseases to the State of California.