Vaccine Temperature Logs for REFRIGERATOR (pdf)
Vaccine Temperature Logs for FREEZER (pdf)
Vaccine Ultra Low Cold Freezer Monthly Temperature Log (pdf)
If you are experiencing out of range temperatures (a temperature excursion), complete the following action items immediately:
Ensure that all vaccine exposed to improper temperatures is marked with “DO NOT USE” signage, notify relevant staff of the excursion and inform them not to use the vaccine.
Store the vaccine at appropriate temperatures.
If there are no vaccine storage units on-site with appropriate temperatures for vaccine storage, follow the process outlined in your facility’s Emergency Plan for Vaccine Relocation. Be sure that temperatures are monitored using a calibrated data logger thermometer at all times, including when stored off-site or in a backup storage unit.
Contact the Immunization Unit to report the temperature excursion by calling 307-777-7952 or emailing email@example.com. The Immunization Unit will be able to provide you with next steps to resolving the temperature excursion.
Note: vaccine cannot be administered until directed by the Immunization Unit staff.
Facility Relocation Notification (online Google form)
Order Volume Justification Form (pdf)
Vaccine Borrowing Report (pdf)
*The Short-Dated Vaccine Transfer Request Form has been replaced with Vaccine Advertisement. See Vaccine Advertisement Quick Reference Guide.
*The Vaccine Return Form has been removed as all returns are now done in the WyIR.