Wyoming Immunization Section - Vaccine Program

Lisa Wordeman

Vaccine Program Specialist 

307-777-2413

 

LaChel May

Provider Relations Administrative Assistant     

307-777-8503

Fax reports to:  307-777-3615

 

WyVIP Providers in Wyoming by County (clickable map) 

 

2010 Benchmarking

Benchmarking Tally Sheet  (Due no later than June 11, 2010) 

Frequently Asked Questions About Benchmarking

 

2010 WyVIP Policy and Enrollment Packets

2010 WyVIP/VFC Policy Packet

2010 Non-PHN Child Agreement

2010 Non-PHN Adult Agreement  

2010 PHN Child Agreement 

2010 PHN Adult Agreement  

 

WyVIP Provider Forms

Vaccines Currently Available through WyVIP (VAC1)  updated 06/16/10

Doses Administered Form (VAC2)  updated 06/16/10

Vaccine Request Form    updated 06/16/10

Special Clinic Order Form (VAC3)  updated 06/16/10

Special Clinic Doses Administered Form (VAC4)  updated 06/16/10

Flu Doses Administered and Inventory Form (VAC5) updated 02/02/10

Expired and Wasted Vaccine Return Form (VAC6)  updated 02/02/10

Vaccine Transfer Form (VAC7)  updated 02/02/10

Vaccine Temperature Log - Celcius (VAC9)  updated 02/02/10

Vaccine Storage Troubleshooting Report    updated 02/02/10

Current Inventory Form (VAC10)  updated 06/16/10

Flu Special Clinic Order Form (VAC11)  updated 02/02/10

Vaccine Transfer Request (VAC12)  updated 02/02/10

Vaccine Arrival Report (VAC13)  updated 06/16/10

      

OTHER INFORMATION

Sharp Shooter Award Information

Handle With Care-Cold Chain Flyer   Updated October 6, 2009

Material Request Form  05/25/10

   Fill out interactive form, print out and fax to 307-777-3615 

Cold Chain and Vaccine Storage and Handling Information

 

Immunization Section Relevant Contacts as of May 2010