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VFC Vaccine Order Form (West Virginia)

This report is used for inventory purposes and includes all publicly supplied vaccines. Header information automatically populates based on the providers Organization (IRMS)/Facility. The following information is entered onto the form:

Run the Report

To run this report, authorized users can click the Reports > State Reports > Vaccine for Children (VFC) > VFC Vaccine Order Form link. The VFC Vaccine Order Form page opens.  Enter the criteria and click Create Report. The report displays in a separate browser tab and can be downloaded and/or printed.

The available report criteria are as follows:

Option Description

Month and Year

Select the month and year from the drop-down lists. Defaults to the current month and year. These fields are required.

Organization (IRMS)
Organization (IRMS) Group

Select either an Organization (IRMS) or Group from the related drop-down list. This field is required.

Facility
Do Not Limit

To limit the form to one specific Facility, select it from the drop-down list.

VFC PIN

To limit the form to one specific VFC PIN, select it from the drop-down list (after which the checkbox is automatically selected).

Example Report

The following image is of an example VFC Vaccine Order Form:

Example VFC Vaccine Order Form for West Virginia

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