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VFC VAR Report (Louisiana)

This generates the Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization form for a specific patient. You must first search for and select a patient. Once the form is generated, you can select checkboxes as needed and print the form.

Run the Report

To generate the form, first search for and select a patient, then click the Reports > State Reports > Patient Specific > VFC VAR link. Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization form opens in a new browser tab. Select checkboxes as needed and print the form using the browser's print function.

Example Report

The following image is of an example VFC VAR report:

Example VFC VAR Report for Louisiana

VFC VAR Complete

This generates the Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization form for a specific patient, and allows for an electronic signature. You must first search for and select a patient. Once the form is generated, you can select checkboxes as needed and print the form.

To generate the form, first search for and select a patient, then click the Reports > State Reports > Patient Specific > VFC VAR Complete link. The VFC VAR page opens. Either accept the current date (default) or change the date, then click Create Form. The Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization opens in a new browser tab, where you can manually select the appropriate checkboxes. To print the form, use the browser's print function.

To capture an electronic signature, read the instructions and click Save Signature.

VFC VAR Blank

This generates a blank Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization form. No specific patient is needed.

To generate the form, click the Reports > State Reports > Other > VFC VAR Blank link. Vaccine Administration Record, Vaccine for Children (VFC) Patient Eligibility Screening, and Registry Authorization form opens in a new browser tab. To print the form, use the browser's print function.

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