Get Nm Vfc Vaccine Administration Form 2015-2025

Completing the NM VFC Vaccine Administration Form online is essential for ensuring accurate record-keeping for vaccinations. This guide will provide step-by-step instructions to help you navigate the form with ease.

Follow the steps to complete the NM VFC Vaccine Administration Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the personal details of the person receiving the vaccine. Required fields are marked with an asterisk (*). Enter the last name, first name, and date of birth in the specified format (mm/dd/yyyy).
3. Provide the mother's maiden name and first name in the designated sections. Indicate the sex of the individual receiving the vaccine by selecting either 'Male' or 'Female'.
4. Fill in the ethnicity section by selecting 'Hispanic' or 'Non-Hispanic'. Complete the mailing address fields including street address, city, state, and zip code.
5. Include home phone and cell phone numbers in the appropriate fields. Enter the name of the responsible person, noting their relationship to the individual receiving the vaccine.
6. Mark the appropriate category under insurance status, selecting from private/commercial insurance options, indicating if no health insurance applies, or checking Centennial Care (Medicaid) if applicable.
7. If applicable, provide the insurance policy numbers in the designated fields to ensure proper documentation.
8. In the clinic use section, include all required vaccination documentation details, such as the vaccine type, manufacturer, lot number, VIS edition date, site/route, and date vaccinated.
9. Ensure all information is accurate and complete before proceeding. Once you finish filling out the form, you can save the changes, download, print, or share the completed document as needed.

Complete your NM VFC Vaccine Administration Form online today to ensure timely and accurate vaccination records.