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philavax@phila.gov

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To onboard a new entity or clinic:

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


On behalf of patients

Patient update request


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PhilaVax program information

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