Program Forms, Resources, and Documents
Below we’ve collected all of our forms, resources, and documents and organized them by program for your convenience. Here you can find all our forms needed for PhilaVax reporting and resources for participating in the VFC and VFAAR programs. We’ve also created documents for to help you manage and maintain your vaccine supply!
If you can’t find what you’re looking for, feel free to email us.
- PhilaVax
- VFC/VFAAR
- TempCheck
- Community Outreach
- Perinatal HepB
- Community Flu Clinics
- Find a Clinic!
PhilaVax Account Forms
Entity Enrollment Form
Clinic Enrollment Form
PhilaVax User Confidentiality Agreement
Determining Correct Funding Code
Opt Out FormPhilaVax Reporting Forms
Reporting Form Instructions
Immunization Record Request
Pediatric Vaccine Reporting Form
Adult Vaccine Reporting Form
No Doses Administered Reporting Form
Flat File Reporting GuideOther Reporting Forms
Patient Update Request
Immunization Record Request
Flu Vaccine Reporting FormGuides & Tips for VFC/VFAAR Providers
Online Ordering: Accepting Shipments Guide
Online Ordering: Ordering Vaccines Guide
Online Ordering: Returning Vaccines Guide
Online Ordering: Tracking Vaccine Shipments