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Forms


Photo of the publication cover. VFC Vaccine Return Form Immunization - Form April 21, 2017

This form is used to return vaccines and to track your inventory. Vaccines that are returned are then cleared from your inventory. Complete and fax this form to the NM VFC Program before you return any vaccines.



Photo of the publication cover. VFC Provider Supply Order Form Immunization - Form April 18, 2016

This form allows providers to order VFC supplies.



Photo of the publication cover. Vaccine Purchase Act W-9 Form Immunization - Form October 7, 2015

This is a sample W-9 form.



Photo of the publication cover. VFC Transport Temperature Log Form for Frozen Vaccines Immunization - Form June 27, 2014

Complete this log when transporting vaccines to an alternate or back-up freezer.

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