Form online 2026

1. Click ‘Get Form’ to open it in our platform's editor.
2. Begin by entering the Child’s Name and Date of Birth. Ensure you include the last name, first name, and middle initial for accurate identification.
3. Next, fill in the Parent/Guardian/Individual of Record's details. This section requires their last name, first name, and middle initial.
4. Input the Provider’s Name following the same format as above. This ensures proper documentation of who is administering the vaccine.
5. For each immunization visit, record the date and mark the appropriate eligibility category based on your assessment. Choose from columns A-D for VFC eligibility or E-G for non-eligibility.
6. Review all entries for accuracy before saving or submitting your form to ensure compliance with VFC requirements.

Start filling out your form online today for free and streamline your documentation process!