Lisa Wordeman
Vaccine Program Specialist
307-777-2413
lisa.wordeman@wyo.gov
LaChel May
Provider Relations Administrative Assistant
307-777-8503
Fax reports to: 307-777-3615
lachel.may@wyo.gov
WyVIP Providers in Wyoming by County (clickable map)
WyVIP Provider Forms
Current Inventory Form (VAC10)
Doses Administered Form (VAC2)
Expired and Wasted Vaccine Return Form (VAC6)
Flu Vaccine Request Form (VAC11)
Influenza Doses Administered and Inventory Form (VAC5)
Special Clinic Order Form (VAC3)
Special Clinic Doses Administered Form (VAC4)
Vaccine Borrowing Form
Vaccine Request Form
Vaccine Storage Troubleshooting Report
Vaccine Transfer Form (VAC7)
Vaccine Temperature Log - Celcius (VAC9)
Vaccine Transfer Request (VAC12)
Vaccines Currently Available through WyVIP (VAC1)
Withdrawal from Program form (VAC13)
OTHER INFORMATION
Immunization Program Relevant Contacts as of February 2012
Vaccine Storage and Handling
VAERS (Vaccination Adverse Event Reporting System)