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SC DHEC Immunization Program Vaccine Order Form Childhood ... 2026

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4.4 out of 5

40 votes

The document is a comprehensive Vaccine Order Form for the South Carolina Department of Health and Environmental Control (DHEC) Immunization Program. It outlines procedures for healthcare providers to order vaccines through various programs, including Childhood Vaccine Programs (VFC and STATE), Adult Vaccine Program, Disease Control, and Employee Health. The form requires detailed inventory information, including doses used, lot numbers, expiration dates, and specific instructions for submission and record-keeping to ensure proper vaccine management.

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Click ‘Get Form’ to open it in the editor.
Enter your Provider's PIN, Name, Address, Phone, and Fax. This information will be pre-printed on the form.
In the 'Completed By' section, print your name and date of completion.
Record the number of VFC doses used since your last order. If none were used, enter '0'.
Input the current inventory of VFC doses on hand for each vaccine, including all lot numbers and expiration dates.
Specify the number of VFC doses requested for each vaccine listed in the order form.
If requesting Menveo doses, make a call for approval to our office before submitting your order.
Ensure that you submit inventories for all programs along with this order to avoid delays in processing.

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2018	4.4 Satisfied (40 Votes)

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