The Department of Health (VDH) has asked NACDS to share their COVID-19 Vaccine Provider Intent form with members. Members who wish or plan to receive the upcoming COVID-19 vaccine through the VDH must fill out and submit this form. If you are planning to receive the vaccine directly from the CDC, you do not need to file the form with VDH. The letter is also available on the VDH Resources for Health Care Professionals web page. As of now, one form is required for each location, however, VDH is looking into whether they can accept a spreadsheet for multiple locations. According to VDH, the physician and physician license number fields should be filled out with the pharmacy location name and pharmacy license number.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.