Enrollment to Receive Oregon State-Supplied Vaccine

Step-by-Step Instructions

• If your clinic wishes to enroll you must contact the Oregon Immunization Program Helpdesk at 1-800-980-9431 or vfc.help@odhsoha.oregon.gov  to begin the enrollment process.
• Please complete the enrollment checklist below to ensure that the process moves as quickly as possible.

If you are from a CCO or health department and are interested in fast-tracking enrollment for a particular site that does not yet participate, please complete this form.

Follow these steps:

1. Print either the VFC Checklist or the VAP Checklist to keep track of your progress through the enrollment process.
   
   
2. Sign up for ALERT Immunization Information System (IIS), if not already enrolled. The ALERT IIS is a statewide immunization registry. ALERT IIS collects immunization data from both public and private health care providers, including pharmacies and hospitals.
   1. Have all staff who will be documenting immunizations, looking up immunization records, or managing vaccine inventory take the Standard User Training.
   2. Have a least one staff take the Super User training. This should be anyone that would have a major role in the program such as the vaccine coordinator, office manager, nursing supervisor, etc.
   3. Have the person who will be ordering vaccine and tracking inventory in ALERT IIS take the Inventory Management Training
   4. Determine how you will get data into ALERT IIS.
   
   
3. Assign a vaccine coordinator, responsible provider, and back-up vaccine coordinator
   1. Responsible Provider: The person responsible for the clinic's overall compliance with state-supplied vaccine program requirements. This is usually the clinic's physician-in chief or the clinic's medical director (A licensed Medical Doctor, Doctor of Osteopathy, Nurse Practitioner, Physician Assistant, or a Naturopathic Doctor).
   2. Vaccine Coordinator: A designated, on-site, and fully trained staff responsible for all vaccine management activities within the practice.
   3. Back-up Vaccine Coordinator: A designated, on-site, and fully trained staff responsible for all vaccine management activities within the practice. This person acts as support to the Vaccine Coordinator and manages the program when the primary coordinator is unavailable.
   
   
4. Fill out enrollment paperwork. All delegate agencies fill out the Public Provider Enrollment Form. Contact the Oregon Immunization Program Helpdesk at 1-800-980-9431 or vfc.help@odhsoha.oregon.gov Updif you are not sure which form to fill out
   • Private VFC Provider Enrollment Form
   • VAP and Public VFC Provider Enrollment Form
   
   
5. Review the Refrigerator and Freezer Guide and Thermometer Guide to determine that your clinic's equipment is in full compliance with program requirements.
   
   
6. Send in one week's worth of maximum and minimum temperature logs and continuous tracking temps.
   • Sample temperature logs
   • How to e-mail continuous tracking temperature logs.
   
   
7. Training: Have at least the Vaccine Coordinator and Back-up Coordinator take vaccine management trainings and send in certificates.
   
   
8. Review Vaccine Management Guide and fill out emergency plan