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Arizona Immunization Program Office, Vaccine Center Phone: (602) 364-3642 Fax: (602) 364-3276 or (602) 364-3232 Wasted/Expired Vaccine Return Form (Fax completed form to Vaccine Center) Provider Name:.

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If expired vaccine is inadvertently is administered, it is considered a vaccine administration error and requires remediation including a VAERS report, contacting the recipient to inform them of the error, and may or may not require revaccination based on the manufacturers' guidance.

VFC records include, but are not limited to, VFC screening and eligibility documentation, billing records, medical records that verify receipt of vaccine, vaccine ordering records, and vaccine purchase and accountability records.

Complete and submit the Spoiled/Expired Returnable Form. This form is available on the VFC website, Resources and Forms page: VFC Resources (pa.gov). Submitting a return form will initiate the request for a shipping label. If providers contact FedEx or UPS directly, there may be a charge for retrieval of the box(es).

CPT 90460 (immunization administration through 18 years via any route of administration, with counseling by physician) allows one (1) unit.

90648 Hemophilus influenza B vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232