VFC Enrollment

• Enrollment Request
  To request an enrollment packet.
• Provider Enrollment
  To submit contact information and agree to the conditions of the program.
• Patient Eligibility Screening | Spanish
  To determine if a child is eligible to receive VFC vaccines.
• Dis-Enrollment
  To leave the VFC program.

Recertification

• Online Provider Recertification
  Recertification is required annually. You can use the online system link above, or this printable PDF form.

Vaccine Inventory Management

• Vaccine Order Form
  To order all available VFC vaccines.
• Vaccine Inventory Form | Drop-down menu version
• Usage Log
• Return/Transfer of VFC Vaccine
• H1N1 Return Transfer Form

Documentation of Tdap Administration or Medical Exemption

• Optional Forms for Health Care Providers

Disease Reporting

• 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.

Patient Care

• Vaccine Adverse Event Reporting System (VAERS)
  VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of US licensed vaccines.