FOR HEALTH CARE PROFESSIONALS
ARKANSAS VFC REPRESENTATIVES BY REGION
Northwest Region West
Gina Cox: gina.cox@arkansas.gov
Northwest Region Central
Judy Cochran: judy.cochran@arkansas.gov
Northeast Region
Marietha McGarity: marietha.mcgarity@arkansas.gov
Central Region
Alicia Clark: alicia.clark@arkansas.gov
Southeast Region
Jamie Martin: jamie.l.martin@arkansas.gov
Southwest Region
Susan Carter: susan.carter@arkansas.gov
VFC State Coordinator
Rachel Odom: rachel.odom@arkansas.gov
VFC PROVIDER TOOLKIT
ENROLLMENT
Enrollment Forms
VFC Provider Agreement-Download to Adobe
VFC Provider Profile-Download to Adobe
VFC Enrollment Packet
Temp Log to Approve a New or Existing Storage Unit
VFC Vaccine Coordinator - Roles and Responsibilities
Arkansas Immunization Registry / WebIZ Information
WebIZ Registration (Arkansas Department of Health Website)
WebIZ HL7 v2.5-a Implementation Guide
Storage and Handling
Vaccine Storage and Handling Toolkit
Temperature Logs Celsius and Fahrenheit (Excel File)
Inventory Management
VFC/SCHIP Order, Available on the WebIZ Home Page
Vaccine Return Form, Available on the WebIZ Home Page
Supplies and Vaccine Administration
Suggested Supplies Checklist for Immunization Clinics
Medical Management of Vaccine Reactions
Vaccine Administration Skills Check List
Vaccine Information Sheets (VIS)
By federal law, you must provide current VIS
Centers for Disease Control and Prevention (CDC) VIS's for all immunizations
Current list of VISs available in 30 languages
Vaccine Adverse Event Reporting System (VAERS)
Resources
New Providers:
Vaccines available through the VFC Program are those recommended by the Advisory Committee on Immunization Practices (ACIP). These vaccines protect babies, young children, and adolescents from 16 diseases. If you are interested in becoming a VFC Provider, please contact the VFC Program at 501.661.2170 or email rachel.odom@arkansas.gov
Re-enrolling Providers:
Please complete the annual training, the Provider Enrollment Form and the Provider Profile and follow the instructions below:
Download and save the Adobe forms to your desktop
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Save each using Clinic Name and VFC Pin# for easy identification
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After saving the forms, complete the information in the forms
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Save the completed forms for your records
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Email a copy of the completed forms with your clinic name and VFC Pin# in the email subject line to rachel.odom@arkansas.gov
