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This version of the form is not currently in use and is provided for reference only. Download this version of
Form SFN53766
for the current year.
Form SFN53766 Vaccine Transfer Form - North Dakota
What Is Form SFN53766?
This is a legal form that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form SFN53766?
A: Form SFN53766 is a Vaccine Transfer Form in North Dakota.
Q: What is the purpose of Form SFN53766?
A: The purpose of Form SFN53766 is to facilitate the transfer of vaccines in North Dakota.
Q: Who needs to fill out Form SFN53766?
A: Healthcare providers and facilities that need to transfer vaccines in North Dakota should fill out Form SFN53766.
Q: Is Form SFN53766 mandatory?
A: Yes, healthcare providers and facilities in North Dakota are required to fill out Form SFN53766 when transferring vaccines.
Q: What information is needed on Form SFN53766?
A: Form SFN53766 requires information about the transferring facility, receiving facility, vaccine details, quantities, and signatures of both parties.
Q: Are there any guidelines or instructions for filling out Form SFN53766?
A: Yes, the North Dakota Department of Health provides detailed instructions on how to fill out Form SFN53766.
Q: Is there a deadline for submitting Form SFN53766?
A: The North Dakota Department of Health recommends submitting Form SFN53766 as soon as possible, ideally before the vaccine transfer.
Q: What should I do with Form SFN53766 after completing it?
A: The completed Form SFN53766 should be kept on file by both the transferring and receiving facilities as documentation of the vaccine transfer.
Form Details:
- Released on January 1, 2013;
- The latest edition provided by the North Dakota Department of Health and Human Services;
- 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 SFN53766 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health and Human Services.
