2022 Annual Training for Vaccines for Children Providers

Annual VFC Required Training Course Completion Confirmation-2022

INSTRUCTIONS:
Each VFC coordinator and backup coordinator need to individually complete the following information. If you are a VFC coordinator at multiple clinics, you will need to complete the following information separately for each clinic that you coordinate.

1. What is your clinic's VFC PIN? It starts with WIA and can be found in WIR or on your packing slips.
Please only include the number portion of your PIN. *This question is required. This question requires a valid number format.

2. What is your clinic's name? *This question is required.

3. What is your first name? *This question is required.

4. What is your last name? *This question is required.

5. What is your role? *This question is required.

Please enter an 'other' value for this selection.

6. What is your email address (We will send the confirmation of completion to this address)? *This question is required. This question requires a valid email address.

7. Please confirm your email address (must match email listed above). *This question is required. This question requires a valid email address.

8. Do you receive our VFC Updates (emails)? *This question is required.