Get Wasted/expired Form - Azdhs

Completing the Wasted/Expired Form - Azdhs online is a straightforward process that ensures the proper reporting of expired or wasted vaccines. This guide provides a step-by-step approach to help you navigate through each section of the form with clarity and confidence.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the provider name in the designated field. This should be the official name of the facility or individual submitting the form.
3. Fill in the PIN assigned to your facility, followed by the contact information. Ensure you provide a reliable contact name to facilitate communication.
4. Complete the address section accurately to ensure proper routing of the return information.
5. Input the telephone number and fax number for your facility to enable follow-up if necessary.
6. Select the vaccine name from the provided list. Make sure to choose the correct vaccine being reported.
7. Indicate the return vial (V) or syringe code (S), as applicable. This helps classify the item being reported.
8. Provide the lot number for the vaccine to ensure accurate tracking and accountability.
9. Select the appropriate return code that corresponds to the reason for the vaccine's waste or expiration. Options include spoiled, expired, lost, etc.
10. Fill in the expiration date for the vaccine being reported. Accurate dates are crucial for compliance and recordkeeping.
11. Enter the number of doses being reported as wasted or expired.
12. Record the cost per dose as well as the total amount. Double-check these values for accuracy.
13. In the section for other approved returns, note any additional information as required.
14. Have the person completing the form print their name, sign, and date the form for verification.
15. After reviewing all entries for accuracy, you can save changes, download, print, or share the form as needed.

Ensure you complete your Wasted/Expired Form - Azdhs online today to maintain compliance and proper vaccine management.