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MARYLAND VFC PROGRAM VACCINE INVENTORY FORM Fax Pages 1 & 2 To: (410) 333-5893 VFC PIN #: (REQUIRED) Today s Date: (REQUIRED) / Name of Physician s Office, Practice, Clinic, Etc.: (REQUIRED) Phone:.

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How to fill out the Vfc Vaccine Inventory Form online

The Vfc Vaccine Inventory Form is an essential document for healthcare providers to report their current vaccine inventory. This guide will walk you through each section of the form to ensure accurate completion.

Follow the steps to effectively fill out the Vfc Vaccine Inventory Form.

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Enter your VFC PIN number in the designated field as it is required for submission.
  3. Fill in today’s date in the required section. Make sure to use the correct format for clarity.
  4. Provide the name of your physician’s office, practice, or clinic in the specified field. This information must be included.
  5. Enter your phone number where required. This ensures the VFC program can contact you if needed.
  6. List any special delivery instructions that may apply, if relevant.
  7. In the vaccine sections, systematically enter the vaccine brand names in alphabetical order along with the corresponding NDC (National Drug Code) numbers for each vaccine you have on hand.
  8. For each vaccine, input the VFC vaccine lot number as required, along with the number of doses on hand and the expiration date. This information is crucial for maintaining accurate inventory.
  9. If you have additional lot numbers for vaccines, repeat the previous step to ensure all details are captured thoroughly.
  10. Once you have filled out all relevant fields, review the form for completeness. Ensure that you have written neatly and clearly to avoid any confusion.
  11. Finally, save your changes, download, print, or share the form as needed for submission.

Complete your VFC Vaccine Inventory Form online today to keep your vaccine inventory secure and compliant.

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The following is a list of diseases that these vaccines prevent: Diphtheria. Haemophilus influenzae type b (Hib) Hepatitis A. Hepatitis B. Human Papillomavirus (HPV) Influenza (flu) Measles. Meningococcal disease.

Note: Healthcare providers cannot refuse to vaccinate your child if you are unable to pay the vaccine administration fee. Other fees the VFC Program provider may charge include: Fees for non-vaccine services that occur during the office visit, like an eye exam or blood test. An office fee for the visit.

To bill Medi-Cal for the VFC dose administration fee, VFC providers shall report the vaccine/toxoid product code(s) with a modifier code of “SL”, which identifies the service as a “state-supplied vaccine”.

The display monitor needs to be visible from the outside of the vaccine refrigerator/freezer storage unit. The data logger must also be able to produce downloadable data of temperature records in 15-minute intervals. The accuracy of the data logger must be within +/- 1-degree Fahrenheit. A buffered temperature probe.

A child is eligible for the VFC Program if they are younger than 19 years of age and are one of the following: Uninsured. Medicaid-eligible or Medicaid-enrolled. American Indian or Alaska Native. Underinsured.

The Vaccines for Children (VFC) program is a federal entitlement program created in 1994 to supply private and public health-care providers with federally purchased vaccines at no cost for administration to eligible children and adolescents in ance with the Recommended Childhood and Adolescent Immunization ...

The Vaccines For Children (VFC) Program supplies vaccines at no cost to providers who serve eligible children from birth through 18 years of age.

The Vaccines for Children (VFC) Program provides vaccines to children whose parents or guardians may not be able to afford them.

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