Form IMM-28 Vaccines for Children (Vfc) Program Patient Eligibility Screening Record - New Jersey

Form IMM-28 Vaccines for Children (Vfc) Program Patient Eligibility Screening Record - New Jersey

What Is Form IMM-28?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form IMM-28?
A: Form IMM-28 is the Vaccines for Children (VFC) Program Patient Eligibility Screening Record.

Q: What is the VFC Program?
A: The VFC Program is a federal program that provides free vaccines for eligible children.

Q: Who is eligible for the VFC Program?
A: Children who are uninsured, underinsured, Medicaid-eligible, or Native American/Alaska Native are eligible for the VFC Program.

Q: What is the purpose of Form IMM-28?
A: Form IMM-28 is used to determine a child's eligibility for the VFC Program and to document their vaccination history.

Q: Is Form IMM-28 specific to New Jersey?
A: Yes, Form IMM-28 is specific to New Jersey and is used for screening and documenting eligibility for the VFC Program in the state.

Q: Do I need to fill out Form IMM-28 for my child's vaccination?
A: If your child is eligible for the VFC Program, you will need to fill out Form IMM-28 to document their eligibility and vaccination history.

Q: Can I use Form IMM-28 for adults?
A: No, Form IMM-28 is specifically for children's eligibility screening and documentation for the VFC Program.

Q: Are all vaccines covered under the VFC Program?
A: No, not all vaccines are covered. The VFC Program provides specific vaccines recommended by the Centers for Disease Control and Prevention (CDC).

Q: How often should I update Form IMM-28?
A: You should update Form IMM-28 whenever your child receives a new vaccination or when there are changes to their eligibility status.

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Form Details:

  • Released on July 1, 2016;
  • The latest edition provided by the New Jersey Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form IMM-28 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.

Download Form IMM-28 Vaccines for Children (Vfc) Program Patient Eligibility Screening Record - New Jersey

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