2008 Wyoming Immunization Program Policies, Procedures and Forms

WyVIP Provider Forms

      Doses Administered Replenishment Form  (VAC2)          

      Special Clinic Order Form (VAC3) 

      Flu Doses Administered Replenishment Form  (VAC5) 

      Inventory Form (VAC10)

      Flu Vaccine Inventory Form (VAC11) 

      Temperature Log-Celcius  (VAC9)  Fahrenheit Not Available

      Vaccine Storage Troubleshooting Form  July 7, 2008

      Flu Prebooking Form for 2008-2009 Flu Season

      Annual Benchmarking Form for 2008   Updated April 21, 2008

      Annual Benchmarking Tally Form for 2008

 

WyVIP Pilot Project

   Online reports that can be emailed in to us

 

Other Forms

      Vaccine Preference Form  (VAC8) 

      Vaccine Arrival Report  

      McKesson Non-Viable Vaccine Return Form  (VAC6)  update June 18, 2008

      Vaccine Transfer Form - Provider to Provider  (VAC7)  update June 10, 2008

      Vaccines Currently Available  (VAC1)  

      Excess Vaccine Transfer Request Form    July 1 ,2008

 

2008 PROGRAM MANUALS & PACKETS (WyVIP 2008 Toolkit Contents)

      WyVIP PROGRAM POLICY PACKET update May 2008     

      Enrollment Packets

            Child-Private Provider/Public Health/Hospitals/Indian Health

            Child-Rural Health and Federally Qualified Health Centers (RHC/FQHC)

            Adult Program Enrollment

      Eligibility Policy Packets

            Child-Private Provider/Public Health/Hospitals/Indian Health

            Child-Rural Health and Federally Qualified Health Centers

            Adult Program Eligibility

                                

      CLINICAL PROGRAM MANUAL

      VACCINE PROGRAM MANUAL

      WyIR PROGRAM MANUAL

 

Materials to Download and Request

      Materials Request Form  June 11, 2008

         Interactive form that can be filled out and emailed to us.

      Vaccine Information Statements (VIS)