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  • Vaccine Management Plan Kentucky Department For Public Health ... - Chfs Ky

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Vaccine Management Plan Kentucky Department for Public Health Immunization Program Provider/Practice Name: VFC PIN: Personnel: 1. is the Vaccine Coordinator for this office. He/She will be responsible.

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Job Aid Date of administration. Vaccine manufacturer. Vaccine lot number. Name and title of the person who administered the vaccine and address of the facility where the permanent record will reside. Vaccine information statement (VIS) Date printed on the VIS. Date the VIS was given to the patient or parent/guardian.

You are required to document receipt of vaccines that are age appropriate for you. The civil surgeon will annotate Form I-693 to indicate that you were not required to receive a particular vaccine because it was not age appropriate at the time of the immigration medical examination.

By law, the following information must be documented on the patient's paper or electronic medical record (or on a permanent office log): The vaccine manufacturer. The lot number of the vaccine. The date the vaccine is administered.

The Vaccines for Children (VFC) program was created by the Omnibus Budget Reconciliation Act of 1993 and implemented in 1994. VFC was created in response to low immunization coverage and the 1989–1991 measles outbreak in the United States.

Required Immunizations in Kentucky Five doses of DTaP or DTP (diphtheria, tetanus, pertussis) or combinations of the two vaccines. Four doses of IPV or OPV (polio) or combinations of the two vaccines. Three doses of hepatitis B. Two doses of MMR (measles, mumps, rubella).

The date the VIS is provided (i.e., the date of the visit when the vaccine is administered). The office address and name and title of the person who administers the vaccine. The date the vaccine is administered. The vaccine manufacturer and lot number.

Visit KYIR Public Portal and follow the steps below to access your immunization record. You will be asked to enter information about yourself or your child to view and download/print records. To access your COVID-19 QR code online, download your COVID-19 Record from the KYIR Public Portal.

The federally required information should be both permanent and accessible. Federal law does not require a parent, patient, or guardian to sign a consent form in order to receive a vaccination; providing them with the appropriate VIS(s) and answering their questions is sufficient under federal law.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232