Forms

Adult Vaccine Return Form Immunization - Form October 10, 2017

This form is used by Healthcare providers to return Adult Vaccines.

Immunization Assessment Worksheet for 7th Grade Immunization - Form September 8, 2017

Immunization Assessment Worksheet for 7th Grade

Immunization Assessment Worksheet for Kindergarten Immunization - Form September 8, 2017

Immunization Assessment Worksheet for Kindergarten

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.

VFC Provider NM Health Passport Order Form Immunization - Form April 18, 2016

This form allows providers to order VFC supplies.

Vaccine Purchase Act W-9 Form Immunization - Form October 7, 2015

This is a sample W-9 form.

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.