Are you concerned about the safety of yourself and/or your family? Then it is essential to know about VFC vaccines, how they work, and when to get them. This blog post will provide an easy-to-follow guide on understanding your vaccination needs through a VFC Vaccine Usage Worksheet Form. You'll learn what questions you should be asking yourself in order to ensure that everyone in your household is receiving proper vaccinations on time and safely. So read on!
| Question | Answer |
|---|---|
| Form Name | Vfc Vaccine Usage Worksheet Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | florida vaccine for children vaccine usage worksheet, vaccine usage worksheet get, vaccine usage waste worksheet, how to register senior for vaccine in fl |
Florida Vaccines for Children (VFC) Program
Vaccine Usage Worksheet
PIN #:_____________
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Patient ID |
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Totals
* Check below the appropriate box for eligibility and vaccines.
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VFC Eligibility* |
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Vaccines* |
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Medicaid |
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No Insurance |
Underinsured |
Am. Indian/AK Native |
Medicaid |
No Insurance |
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Underinsured |
Am. Indian/AK Native |
Medicaid |
No Insurance |
Underinsured |
Am. Indian/AK Native |
Medicaid |
No Insurance |
Underinsured |
Am. Indian/AK Native |
DTaP |
DTaP/Hep B/IPV |
Kinrix |
Pentacel |
Hep A |
Hep B |
Hep B/Hib |
Hib |
HPV |
EIPV (Polio) |
Meningococcal |
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MMR |
Rotavirus |
Rotarix |
Td |
Tdap |
Flu (0.25ml) |
Flu (0.50mi) |
FluMist |
Varicella |
MMRV |
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Record the total number of children immunized
by age and VFC eligibility
Medicaid
No Insurance
Underinsured
American Indian/Alaskan Native
TOTAL CHILDREN IMMUNIZED
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<1 YEAR |
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Mailing Adrress:
FL Department of Health
Bureau of Immunization
4052 Bald Cypress Way, Bin
Tallahassee, Florida
Fax: (850)
Phone:
Revised September 2008