Vaccine Protocol Registration

GCMB has been designated caretaker for the Vaccine Protocol Agreement process. Please find below the application material to submit for Vaccine Protocol Agreement registration.

If you have any questions regarding the process, contact:


Download this pdf file.Letter from DPH to Pharmacist regarding Vaccine records and process

Forms

Download this pdf file.General Information and Checklist

Download this pdf file.Vaccine Protocol Agreement Form with Alternate Physician

Download this pdf file.Vaccine Protocol Agreement Form without Alternate Physician

Download this pdf file.Affidavit for Vaccine Protocol Agreement