All Forms Grouped Together (same as CD)

• FQHC/RHC (if your PIN begins with "F")
• Private/Public

Provider & Eligibility Forms

• Eligibility Form - English
• Eligibility Form - Spanish
• Provider Profile and Enrollment Form

Report Forms

• FQHC/RHC Doses Administered Report (if your PIN begins with "F")
• Private/Public Providers Doses Administered Report
• Special Project Doses Administered Report

Storage & Handling

• Emergency Response Worksheet
• Temperature Log (C)
• Temperature Log (F)
• Training Quiz & Checklist
• Vaccine Handling Plans Template
• Vaccine Management Guidebook
• Vaccine Spoilage Checklist

Tally Sheets

• CHIP Tally Sheet
• FQHC/RHC Tally Sheet (if your PIN begins with "F")
• Special Project Tally Sheet
• Under-Insured Tally Sheet
• VFC Tally Sheet (for all ages)

Vaccine Forms

• Influenza Vaccine Order Form 2009
• Vaccine Administration Record
• Vaccine Inventory Form
• Vaccine Order Form
• Vaccine Return and Transfer Form

USIIS Forms and Manuals

• New User / Security Agreement
• Provider Enrollment Packet
• Desktop Reference Manual
• Vaccine Code List

Hospital Hep B Forms

• Hep B Birth Dose Order Form
• Hep B BIrth Doses Administered Report
• Hep B Birth Dose Enrollment Form
• Storage and Handling

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