Get Expired /spoiled Vaccines Return Form - Nyc . Gov - Nyc

Filling out the Expired/Spoiled Vaccines Return Form is a crucial process for healthcare providers to report vaccines that are no longer usable. This guide provides a clear and structured approach to help you complete the form accurately and efficiently.

Follow the steps to complete the form successfully.

1. To begin, click the ‘Get Form’ button to access the form online. This allows you to view and edit the document seamlessly.
2. Fill in the 'Date' field at the top of the form. This should reflect the date when you are completing the form.
3. Enter the provider information in the designated area. Include your organization's name and any additional identifying details.
4. In the 'Contact Name' field, provide the name of the person responsible for this submission. This helps facilitate communication about the returned vaccines.
5. Input your VFC Pin in the corresponding section. This identifier is essential for processing your return accurately.
6. Include the contact phone number where you can be reached. This ensures that the department can reach out for any clarifications if needed.
7. Fill in the 'Title' section to reflect your position within your organization. This adds credibility to the form.
8. List the details of the expired or spoiled vaccines in the table provided. Include the vaccine type, brand name, manufacturer, number of doses, lot number, and expiration date.
9. For each vaccine, indicate the reason for return, either ‘Spoiled’ or ‘Expired’. Ensure that each entry is clear and correctly classified.
10. In the final section, provide details regarding the reason(s) for vaccine spoilage and any temperature irregularities, if applicable. Use an additional sheet if necessary.
11. Once all fields are filled out completely, review the form for accuracy. Make any necessary corrections to enhance clarity.
12. After verifying the information, save the changes. You have the option to download, print, or share the completed form as needed.

Complete your documentation online today and ensure the proper return of expired or spoiled vaccines.