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Photo of the publication cover. VFC School Immunization Consent Form Immunization - Form August 17, 2022

This is the form to be completed by parents or guardians indicating whether or not a child is to be vaccinated at school.

VFC School Immunization Consent Form (Spanish)



Photo of the publication cover. VFC Vaccine Administration Form (Part B) Immunization - Form August 17, 2022

This form allows you to provide immunization information for entry into NMSIIS.

VFC Vacuna Forma Administración (Parte B)



Photo of the publication cover. CDC-Revised document as COVID-19 Vaccine Program Provider Agreement Immunization - Form May 18, 2022

CDC-Revised document as COVID-19 Vaccine Program Provider Agreement



Photo of the publication cover. CDC-Supplemental document as COVID-19 Vaccine Redistribution Agreement Immunization - Form May 18, 2022

CDC-Supplemental document as COVID-19 Vaccine Redistribution Agreement



Photo of the publication cover. Adult Vaccine Consent Form Immunization - Form October 1, 2021

This form may be used by adult patients aged 19 and older to provide vaccination consent to a healthcare provider.

Adultos Vacuna Formulario de Consentimiento



Photo of the publication cover. Adult TSR Form Immunization - Form August 30, 2021

Adult TSR Form





Photo of the publication cover. COVID-19 Vaccine Consent Form English Immunization - Form March 25, 2021

This form should be used as Consent for COVID-19 Vaccinations



Photo of the publication cover. COVID-19 Vaccine Consent Form Spanish. Immunization - Form February 25, 2021

This form should be used as Consent for COVID-19 Vaccinations



Photo of the publication cover. COVID-19 Vaccine Consent Form Spanish Immunization - Form December 18, 2020

This form should be used as Consent for COVID-19 Vaccinations



Photo of the publication cover. VFC COVID-19 Troubleshooting Record Form Immunization - Form December 15, 2020

This form should be used to report out of range temperature incidents and submit a troubleshooting record to the vaccines for children program.



Photo of the publication cover. VFC Northwest Region Temperature Log Form Immunization - Form June 29, 2020

Cibola, McKinley, San Juan, Sandoval, Torrance, and Valencia



Photo of the publication cover. VFC Southeast (A) Region Temperature Log Form Immunization - Form June 29, 2020

Chaves, Curry, DeBaca, Lincoln, and Quay



Photo of the publication cover. VFC Southeast (B) Region Temperature Log Form Immunization - Form June 29, 2020

Eddy, Lea, Lincoln, and Roosevelt



Photo of the publication cover. School Consent to Enter Student Records into NMSIIS Immunization - Form September 17, 2018

This is a customizable form for use by schools to collect consent from parents so students' historic immunization records may be added to NMSIIS.



Photo of the publication cover. VFC Approved School Sites - Needle, Syringe, & e-kit Order Form Immunization - Form February 23, 2018

This form is to be used for needles/syringes, and e-kit medications and is for Vaccines for Children Approved Sites Only.



Photo of the publication cover. VFC Middle School Vaccination Letter/Permission Form Immunization - Form February 23, 2018

This is the letter addressed to parents or legal guardians to determine whether or not a child is to be vaccinated at school. This letter is to be sent out with the VFC school immunization consent form.

VFC Middle School Vaccination Letter/Permission Form (Spanish)

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