Arizona VFC Incident Reporting
This form provides a convenient way to report cold storage and temperature related incidents to the Arizona VFC Program.
After the form is submitted the Arizona Immunization Office staff will:
- Review the incident report
- Provide recommendation and guidance
- Follow up on the incident.
The Form works best with Google Chrome.
Some of the form functionalities may be limited in other browsers like Internet Explorer, Edge, Opera, Mozilla Firefox, Safari, etc.
Please fill out all required fields and provide as much details
Submitting incomplete data in the incident report may delay the process and may result in returning the incident report back to the submitter.
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