Instructions: Providers are required to notify the VFC Program if there are changes in:
- Key VFC staff - Add all new & existing contacts. Contacts not listed on this form will be removed from the account.
- Days or hours of operation
- Shipping or mailing address
- Staff contact information including email addresses, phone or fax numbers.
This online form cannot be saved. Be prepared to UPLOAD the VFC annual training certificates before starting this form.
Training certificates required for:
- NEW Primary Vaccine Coordinator
- NEW Secondary Vaccine Coordinator
- NEW Provider of Record (MD, DO, PA, NP)
Hit the SUBMIT button at the end of this form. After submitting the form, an email confirmation will be sent. Keep a copy of the VFC Change of Information form for your records.
VFC Program Contact information: 303-692-2650 or cdphe_VFC@state.co.us