Transcription of VACCINE FOR CHILDREN (VFC) PROGRAM …
1 VACCINE FOR CHILDREN (VFC) PROGRAMR efrigerated VACCINE Transport LogDate: I M M -113 2 (11/ 16 )Instructions: Complete this log when transporting vaccines to your alternate VACCINE storage Name: PIN:Transferred to: PIN: VACCINE transferred due to: Power outage Excess supply Short dated Unit malfunction Building maintenance OtherTemperature of VACCINE in refrigerator prior to transfer: C/F Time:Temperature of VACCINE in cooler before departure: C/F Time:Temperature of VACCINE in cooler upon arrival: C/F Time:Temperature of alternate VACCINE storage unit: C/F Time: Total Transport time: Min/HrVaccine Inventory InformationVaccineLot NumberNumber of DosesExpiration DateVaccine previously transported?
2 ( Yes/No)CommentsTemperature Monitoring InformationContact the VFC Call Center at (877-243-8832) if temperatures during transport exceed recommended ranges.
