The Review and Sign page enables the Medical Director or Equivalent
to review the enrollment form, sign, and submit to IIP. This page is accessible
only to Medical Director or Equivalent. The Medical Director or Equivalent
will receive an e-mail when the form was completed and submitted to the
Medical Director or Equivalent for review and sign.
The Review and Sign page displays the enrollment form pages (Provider
Agreement, Provider Enrollment,
Provider Profile, and Vaccine
Brand Choice) as read only forms as well as provides an option to
edit the individual pages displayed for each of these pages (except Provider Agreement).
The Review and Sign page captures the below information.
Field
Name |
Description |
Medical Director or Equivalent |
Required field. Full Name of
the Medical Director or Equivalent. The field is used to electronically
sign the VFC Re-enrollment form. |
Date |
Required field. The date the
Medical Director or Equivalent electronically signed the VFC Re-enrollment
form. |
Idaho
Immunization Program (IIP) Provider Policies and Guidelines |
Required field. Check box to
acknowledge compliance with the Idaho Immunization Program
(IIP) Provider Policies and Guidelines. |
Vaccines
for Children enrollment requirements |
Required
field. Check box to acknowledge
compliance with the Vaccines for Children enrollment requirements
listed in the Provider Agreement. |
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The Review and Sign process is completed in two steps.
Step1: Entering
the details and acknowledging the Policies, Guidelines and Agreements
(as described in the above table) and then click 'Save
and Generate' which will display the below second step.
Step2: Verify
that the VFC Provider Re-Enrollment Packet is generated successfully
and at which point the Medical Director or Equivalent can submit the
VFC Provider Re-Enrollment Packet to IIP.
Button |
Description |
|
Clicking
Save
and Generate will
display the second screen which shows the VFC Provider Re-Enrollment
Packet status. The initial status is 'Queued' with
no links to view the packet. The page is automatically reloaded
when the report is generated and a link will be provided with
name as 'VFCProviderPacket_Report'. The report status is changed
to 'Done'. Clicking on this link will
open a printable PDF file of the complete VFC Provider Re-Enrollment
Packet. |
|
Clicking
Cancel takes the user to IRIS portal
home page. |
|
Clicking
Submit to Idaho Immunization
Program
e-mails the VFC Provider Re-Enrollment Packet PDF to IIP. This
completes the VFC Re-enrollment process.
Note:
The
Submit to Idaho Immunization
Program
button will not be available if the
VFC
Provider Re-Enrollment Packet is not generated successfully. |
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