Tvfc eligibility form 2013-2025

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A child is eligible for the VFC Program if they are younger than 19 years of age and are one of the following: Uninsured, Medicaid-eligible or Medicaid-enrolled, American Indian or Alaska Native, or Underinsured.
Screening to determine VFC eligibility and documenting the current VFC eligibility category must take place at each immunization visit prior to administering vaccines.
Disclaimer Note: Healthcare providers cannot refuse to vaccinate your child if you are unable to pay the vaccine administration fee.
Underinsured children are eligible to receive VFC Program vaccine only through a Federally Qualified Health Center (FQHC), or Rural Health Clinic (RHC) or under an approved deputization provider location agreement.
In ance with federal law, VFC providers must maintain immunization records that include ALL of the following elements: (1) name of vaccine administered; (2) date vaccine was administered; (3) date VIS was given; (4) publication date of VIS; (5) name of vaccine manufacturer; (6) vaccine lot number; (7) name and
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