Get Vaccine Order Form For Parents Vaccine Education Center - Chop

The Vaccine Order Form for Parents is an essential document that allows individuals to request vaccinations and educational materials from the Vaccine Education Center at The Children's Hospital of Philadelphia. This guide provides clear, step-by-step instructions to assist you in completing the form efficiently and accurately.

Follow the steps to complete the Vaccine Order Form for Parents

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Fill in your name in the designated field. Ensure that the name you provide is accurate and reflects your identification.
3. Enter your street address in the provided field. This should include any relevant information such as apartment numbers or building names.
4. Complete the city, state, and zip code fields accurately. These details are essential for processing your order.
5. Provide your telephone number and email address. The email address will be used to send you important updates regarding vaccine safety.
6. In the ordering information section, indicate the quantity of the DVD you wish to order. The DVD costs $5, plus shipping.
7. Calculate the total cost, keeping in mind to check for updated shipping costs by calling or consulting the website.
8. Prepare a check or money order made payable to “Vaccine Education Center” for the total amount. Ensure this is done before submitting the form.
9. Send the completed form along with your payment to the specified address: Vaccine Education Center, The Children’s Hospital of Philadelphia, 3615 Civic Center Boulevard, ARC 1202, Philadelphia, PA 19104-4318. Attention: Denise Freeman.
10. After sending the form and payment, your order will be processed, and expect delivery within three to four weeks.

Act now to fill out and submit your Vaccine Order Form online for timely processing.