{"id":10566,"date":"2024-08-28T10:40:44","date_gmt":"2024-08-28T14:40:44","guid":{"rendered":"https:\/\/vaccines.phila.gov\/?post_type=portfolio_page&#038;p=10566"},"modified":"2026-02-09T09:57:20","modified_gmt":"2026-02-09T14:57:20","slug":"reporting-forms","status":"publish","type":"portfolio_page","link":"https:\/\/vaccines.phila.gov\/index.php\/portfolio_page\/reporting-forms\/","title":{"rendered":"Reporting Forms"},"content":{"rendered":"\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full multiple-resource-gallery is-style-default\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form.png\" alt=\"\" class=\"wp-image-13017\" style=\"aspect-ratio:1;object-fit:cover\" srcset=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form.png 600w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-480x480.png 480w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-150x150.png 150w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-570x570.png 570w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-500x500.png 500w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-300x300.png 300w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/adult-vaccine-reporting-form-100x100.png 100w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><figcaption class=\"wp-element-caption\"><a href=\"\/wp-content\/uploads\/2026\/02\/Adult-Vaccine-and-Immunization-Reporting-Form-2-2-2026.pdf\" data-type=\"link\" data-id=\"\/wp-content\/uploads\/2026\/02\/Adult-Vaccine-and-Immunization-Reporting-Form-2-2-2026.pdf\">Adult Vaccine Reporting Form<\/a><\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full multiple-resource-gallery\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form.png\" alt=\"\" class=\"wp-image-13018\" style=\"aspect-ratio:1;object-fit:cover\" srcset=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form.png 600w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-480x480.png 480w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-150x150.png 150w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-570x570.png 570w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-500x500.png 500w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-300x300.png 300w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/pediatric-vaccine-reporting-form-100x100.png 100w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><figcaption class=\"wp-element-caption\"><a href=\"\/wp-content\/uploads\/2026\/02\/Pediatric-Vaccine-Reporting-Form-2-2-2026.pdf\" data-type=\"link\" data-id=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/03\/Pediatric-Vaccine-Reporting-Form-ResourceForms-3-11-2025.pdf\">Pediatric Vaccine Reporting Form<\/a><\/figcaption><\/figure>\n<\/div>\n<\/div>\n\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full is-resized multiple-resource-gallery\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form.png\" alt=\"\" class=\"wp-image-13013\" style=\"object-fit:cover;width:554px;height:auto\" srcset=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form.png 600w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-480x480.png 480w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-150x150.png 150w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-570x570.png 570w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-500x500.png 500w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-300x300.png 300w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/10\/flu-reporting-form-100x100.png 100w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><figcaption class=\"wp-element-caption\"><a href=\"\/wp-content\/uploads\/2026\/02\/Flu-Vaccine-Reporting-Form-1-12-2026.pdf\" data-type=\"link\" data-id=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2025\/03\/Flu-Vaccine-Reporting-Form-ResourceForms-3-5-2025.pdf\">Flu Vaccine Reporting Form<\/a><\/figcaption><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full is-resized multiple-resource-gallery\"><a href=\"\/wp-content\/uploads\/2024\/08\/v1NoDoseAdministered_PhilaVax_11-20-20.pdf\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"600\" src=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01.jpg\" alt=\"\" class=\"wp-image-10575\" style=\"object-fit:cover;width:554px;height:auto\" srcset=\"https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01.jpg 600w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-480x480.jpg 480w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-150x150.jpg 150w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-570x570.jpg 570w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-500x500.jpg 500w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-300x300.jpg 300w, https:\/\/vaccines.phila.gov\/wp-content\/uploads\/2024\/08\/no-dose-report-01-100x100.jpg 100w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/a><figcaption class=\"wp-element-caption\"><a href=\"\/wp-content\/uploads\/2024\/08\/v1NoDoseAdministered_PhilaVax_11-20-20.pdf\">No Dose Administered Reporting 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