Get Influenza/pneumococcal Outreach 2006-07 Vaccine Tracking Form - Nyc

The Influenza/Pneumococcal Outreach 2006-07 Vaccine Tracking Form is designed to help healthcare providers track the distribution of vaccines issued by the New York City Department of Health. This guide provides a clear, step-by-step approach to completing the form online.

Follow the steps to successfully complete the vaccine tracking form.

1. Click ‘Get Form’ button to access the vaccine tracking form and open it in your preferred online editor.
2. Begin by entering the site name where vaccinations are being administered in the designated space. This ensures proper tracking and accountability.
3. Next, if applicable, note the clinic or practice name if you are working within a larger facility. This provides additional context for the records.
4. Fill in the complete address of the vaccination site. Accurate details help in verifying the location of vaccine administration.
5. Provide a contact phone number in the specified field, ensuring that the Health Department can reach you if necessary.
6. Enter the total number of vials supplied by the Department of Health and Mental Hygiene into the appropriate section. This information is critical for tracking vaccine distribution.
7. As you administer vaccines, keep a tally by marking each shot given in the corresponding rows provided for both influenza and pneumococcal vaccines.
8. Once your supply is depleted, count the number of marks per row and record the total doses given in the provided fields for both age groups and vaccine types.
9. Finally, have the person completing the form sign and print their name in the designated area. This ensures accountability for the data reported.
10. Once the form is completed, save any changes and proceed to download or print a copy for your records. Share the finalized form with your Health Department representative as required.

Complete your vaccine tracking form online today to contribute to public health efforts.