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Provider Portal: PROVIDER ENROLLMENT/WITHDRAWAL

Are You Ready To Join the Team!

All Wyoming immunization providers are welcome to participate in the VFC and WyVIP Programs. Only public providers may enroll in the VUA and AHV Programs; however, private providers will be considered for participation on a case by case basis.

 

If you are interested in learning more about the Public Vaccine Programs be sure to review the Vaccine Program Overviews at the links below.

Vaccines for Children (VFC) and Wyoming Vaccinates Important People (WyVIP) Programs

Vaccines for Uninsured Adults (VUA) Program

Adult Hepatitis Vaccine (AHV) Program

 

We have also put together a pamphlet to further help you decide if participation is right for you and your staff.

VFC/WyVIP Pamphlet For Providers NEW!

 

When you are ready to move forward, please contact the Jude Alden, VFC Coordinator at 307-777-2913 or jude.alden@wyo.gov.

 

Enrollment Resources

Provider Enrollment Process (01/13/15)

Provider Profile (01/13/15)

Vaccine Coordinator Checklist (12/01/14)

 


 Program Withdrawal

Providers that are enrolled in a Public Vaccine Program who wish to withdrawal must complete the following process and form.

Providers are financially responsible for publicly-supplied vaccines until they are safely transferred to another provider under the approval of the Immunization Program.

Withdrawal Process (11/06/14)

Withdrawal Form (5/01/14)

   

 

  


 

 

 

 

 

 

 

 

 

 

 

 

 

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