Forms and Resources

Program Forms, Resources, and Documents

This page contains our entire library of forms, resources, documents, and guides. Each is organized by their related program or function for your convenience. You can also find these resources at the bottom of their respective pages throughout our website.

Please use the quick-links below to help find your resource faster. Having trouble locating a resource? Email us at vaccines@phila.gov for help!

PhilaVax

VFC/VFAAR

Enrollment

VFC/VFAAR Enrollment Job Aid
Staff Changes Job Aid
Primary Agreement Signature Guide

VFC Site Visit Folder Resource

10 Tips For VFC
Vaccine Coordinator Guide
VFC Eligibility Guide
VFC Eligibility Screening Record

Other Resources

Avoiding Administration Errors: Scheduling Errors
PhilaVax Recall Report Guide
Online Ordering: Inventory Management Job Aid
VFC and COVID-19 Vaccination Program Comparison
Reference Guide for VFC/VFAAR Vaccine Ordering

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Community Outreach

Immunization Requirements for Providers

Board of Health Regulations Governing the Immunization and Treatment of Newborns, Children, and Adolescents
PA Department of Health School Immunization Requirement Resources
Recommended Child and Adolescent Immunization Schedule for Ages 18 years or Younger
School District of Philadelphia Office of Student Health Services

Immunization Requirements Resources for Parents

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Perinatal Hep B

Resources

Asian Liver Center – Stanford University
Hepatitis B General Information Fact Sheets (CDC)
Hepatitis B and Sexual Health
Hepatitis B Vaccination of Infants, Children, and Adolescents (CDC)
Information for Gay/Bisexual Men (CDC)
Protect Your Baby for Life (CDC)
When Someone Close To You Has Hepatitis B (CDC)

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COVID-19

COVID-19 Enrollment

Comprehensive COVID-19 Provider Guide to the Enrollment Process
COVID-19 Vaccine Provider Agreement Guide
COVID-19 Vaccine Provider Agreement Form and Survey
VFC and COVID-19 Vaccination Program Comparison

Pfizer’s COVID-19 Vaccine Management

Pfizer 6 Month-4 Years

Beyond-Use Date Box Label Instruction Sheet (Pfizer 6mon-4year)
Beyond-Use Date Printable Box Labels (Pfizer 6mon-4year)
Beyond-Use Date Printable Vial Labels (Pfizer 6mon-4year)
Beyond-Use Date Vial Label Instruction Sheet (Pfizer 6mon-4year)
COVID-19 Vaccine Dose Tracker Sheet (Pfizer 6mon-4year)

Pfizer 5-11 Years Bivalent

Beyond-Use Date Box Label Instruction Sheet (Pfizer 5-11 Bivalent)
Beyond-Use Date Printable Box Labels (Pfizer 5-11 Bivalent)
Beyond-Use Date Printable Vial Labels (Pfizer 5-11 Bivalent)
Beyond-Use Date Vial Label Instruction Sheet (Pfizer 5-11 Bivalent)
COVID-19 Vaccine Dose Tracker Sheet (Pfizer 5-11 Bivalent)

Pfizer 5-11 Years Monovalent

Beyond-Use Date Box Label Instruction Sheet (Pfizer 5-11 Monovalent)
Beyond-Use Date Printable Box Labels (Pfizer 5-11 Monovalent)
Beyond-Use Date Printable Vial Labels (Pfizer 5-11 Monovalent)
Beyond-Use Date Vial Label Instruction Sheet (Pfizer 5-11 Monovalent)
COVID-19 Vaccine Dose Tracker Sheet (Pfizer 5-11 Monovalent)

Pfizer 12+ Years Bivalent

Beyond-Use Date Box Label Instruction Sheet (Pfizer 12+ Bivalent)
Beyond-Use Date Printable Box Labels (Pfizer 12+ Bivalent)
Beyond-Use Date Printable Vial Labels (Pfizer 12+ Bivalent)
Beyond-Use Date Vial Label Instruction Sheet (Pfizer 12+ Bivalent)
COVID-19 Vaccine Dose Tracker Sheet (Pfizer 12+ Bivalent)

Pfizer 12+ Years Monovalent

Beyond-Use Date Box Label Instruction Sheet (Pfizer 12+ Monovalent)
Beyond-Use Date Printable Box Labels (Pfizer 12+ Monovalent)
Beyond-Use Date Printable Vial Labels (Pfizer 12+ Monovalent)
Beyond-Use Date Vial Label Instruction Sheet (Pfizer 12+ Monovalent)
COVID-19 Vaccine Dose Tracker Sheet (Pfizer 12+ Monovalent)

Moderna’s COVID-19 Vaccine Management

Moderna 6 Month-5 Years

Beyond-Use Date Box Label Instruction Sheet (Moderna 6mon-5year)
Beyond-Use Date Printable Box Labels (Moderna 6mon-5year)
Beyond-Use Date Printable Vial Labels (Moderna 6mon-5year)
Beyond-Use Date Vial Label Instruction Sheet (Moderna 6mon-5year)
COVID-19 Vaccine Dose Tracker Sheet (Moderna 6mon-5year)

Moderna 6-11 Years

Beyond-Use Date Box Label Instruction Sheet (Moderna 6-11)
Beyond-Use Date Printable Box Labels (Moderna 6-11)
Beyond-Use Date Printable Vial Labels (Moderna 6-11)
Beyond-Use Date Vial Label Instruction Sheet (Moderna 6-11)
COVID-19 Vaccine Dose Tracker Sheet (Moderna 6-11)

Moderna 12+ Years

Beyond-Use Date Box Label Instruction Sheet (Moderna 12+)
Beyond-Use Date Printable Box Labels (Moderna 12+)
Beyond-Use Date Printable Vial Labels (Moderna 12+)
Beyond-Use Date Vial Label Instruction Sheet (Moderna 12+)
COVID-19 Vaccine Dose Tracker Sheet (Moderna 12+)

Moderna 6+ Years Bivalent Booster

Beyond-Use Date Box Label Instruction Sheet (Moderna 6+ Bivalent Booster)
Beyond-Use Date Printable Box Labels (Moderna 6+ Bivalent Booster)
Beyond-Use Date Printable Vial Labels (Moderna 6+ Bivalent Booster)
Beyond-Use Date Vial Label Instruction Sheet (Moderna 6+ Bivalent Booster)
COVID-19 Vaccine Dose Tracker Sheet (Moderna 6+ Bivalent Booster)

Janssen’s (J&J) COVID-19 Vaccine Management

COVID-19 Vaccine Dose Tracker Sheet (J&J)

COVID-19 General Vaccine Management

COVID-19 Redistribution Tracking Guide
COVID-19 Vaccines Quick Reference Guide
Vaccine Expiration Tracking Sheet
Vaccine Finder Training Video for COVID-19 Providers
Wastage Adjustment Job Aid
Vaccinator Authorization Form

COVID-19 Online Ordering

Ordering COVID-19 Vaccine
Online Ordering Training Video
Reference Guide for COVID-19 Vaccine Ordering

Pfizer’s COVID-19 Vaccine Training Materials

Dry Ice Safety
CDC BUD Tracking Labels (Pfizer)
Pfizer Preparation and Administration Summary
Pfizer Storage Summary
CDC Storage Label (Pfizer)
CDC COVD-19 Vaccine Expiration Date Tracker

Moderna’s COVID-19 Vaccine Training Materials

Moderna Vaccine Wastage Guide
CDC BUD Guidance and Labels (Moderna)
Moderna Preparation and Administration Summary
Moderna Storage Summary
CDC Storage Label (Moderna)
Moderna Transporting Vaccine to Off-Site Clinic
CDC COVID-19 Vaccine Expiration Date Tracker

Janssen’s (J&J) COVID-19 Vaccine Training Materials

Janssen Preparation and Administration Summary
Janssen Storage Summary
CDC Storage and Handling Labels (Janssen)
Janssen Transporting Vaccine to Off-Site Clinic
CDC COVID-19 Vaccine Expiration Date Tracker

City, State, and Federal COVID-19 Resources

12 Things Jurisdictions Need to Know About VAERS
CDC COVID-19 Communication Toolkit
CDC COVID-19 Vaccine Safety
CDC Vaccine Schedules
COVID-19 Vaccine Providers in Pennsylvania
Persons Authorized to Administer COVID-19 Vaccinations in Pennsylvania
Philadelphia Health Department’s COVID-19 Website
Philadelphia Health Department’s Health Information Portal

Improving COVID-19 Vaccine Acceptance

Communication Strategies: Raising Vaccination Rates During COVID-19
From Concern to Confidence: How Physicians Can Build Trust in COVID-19 Vaccines
Talking Points: The Importance of Vaccinating During COVID-19
The Immunizer and the COVID-19 Vaccines Comic

Vaccinating Adolescents With COVID-19 Vaccine

ACIP Interim Recommendation for Use of Pfizer for Adolescents Age 12-15
CDC Interim Recommendations for COVID-19 Vaccine Use
Emergency Order Concerning COVID-19 Vaccine Information

PhilaVax Immunization Record Request Forms

PhilaVax Immunization Record Request Form (English)
PhilaVax Immunization Record Request Form (Spanish)
PhilaVax Immunization Record Request Form (Mandarin)
PhilaVax Immunization Record Request Form (Vietnamese)
PhilaVax Immunization Record Request Form (Korean)

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Homebound Vaccine Provider Toolkit

Philadelphia Health Department Resources

COVID Vaccine Needs for Homebound Persons Registration Form
Guidance for Vaccinating Older Adults and People with Disabilities: Ensuring Equitable COVID-19 Vaccine Access
Homebound Vaccination Flyers (available in English, Spanish, Simplified Chinese, Vietnamese, Russian, & French)
Homebound Vaccination Program for Older Adults and People with Disabilities
Vaccinating Homebound Persons with COVID-19 Vaccine
Resources for In-Home Vaccine Providers

Trainings & Presentations

Achieving Health Equity for People with Disabilities During the Pandemic and Beyond
Creating an Ouch-less Vaccine Experience for All
Cultural Competency: Serving the Disability Community
Immunization Courses: Webcasts and Self-Study
Vaccine Adverse Event Reporting System (VAERS) Training – Coming Soon!

Community Resources

Community Legal Services

Center City Office (1424 Chestnut Street, Philadelphia, PA 19102 | 215-981-3700)
North Philadelphia Office (1410 W. Erie Avenue, Philadelphia, PA 19140 | 215-227-2400)
Landlord Tenant Help Center (1339 Chestnut Street, 10th Floor, Philadelphia, PA 19103)

Philadelphia Legal Assistance (718 Arch Street, Suite 300N, Philadelphia, PA 19106 | 215-981-3800)
Partnership for Inclusive Disaster Strategies