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philavax@phila.gov
215-685-6784
215-238-6944
Complete the online reporting agreement form
Or fill out the
Reporting agreement form
then email it to vaxreporting@phila.gov or fax to the contact above.
Clinic onboarding list
Complete in addition to the reporting agreement form to onboard more than 2 clinics.
Need help? Review the FAQ
Reporting agreement FAQ
Patient update request
PhilaVax program information
Flat file reporting guide
More PhilaVax resources