Arizona Immunization Program
Vaccines for Children (VFC)
Please type information into the enrollment documents and print to sign. VFC enrollment documents that are missing information will be returned for completion. If you are a first time VFC applicant please call the VFC office at 602-364-3642 before completing the enrollment packet.
Providers who completed re-enrollment in 2014 will remain valid until 2016. Re-enrollment for 2016 will begin in late spring or early fall of 2015. More information on this will occur later in 2015.
- 2015 Arizona VFC Provider Enrollment Agreement
- 2015 VFC Provider Profile
- 2015 VFC Provider Profile (VFC DEPUTIZED, County Health Department, FQHC, RHC ONLY)
- 2015 VFC Refrigerator-Freezer Verification Statement
- 2015 VFC Provider ASIIS and VOMS User Information
- 2015 ASIIS HIPAA Pledge to Protect Confidential Information
- 2014 Policy and Procedure Manual for Providers in the Arizona VFC Program