Alameda County Public Health Department Flu Distribution Program Usage Report

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Alameda County Public Health Department Flu Distribution Program Usage Report - FIRST REPORT

Please submit your clinic information to Alameda County for compilation and re-submission to the state, as agreed to in the Usage Agreement Form your agency signed.

You will require the following information to complete this form:
1. Amount of each vaccine type your organization received, administered, wasted and have left.
2. The age groups of patients who received doses of each type of vaccine

First Submission Due Date: February 8th, 2019

Note that a second Flu Distribution Program Usage Report will be due that will ask for information about flu vaccine administered after the submission of this form. Record the vaccine submitted here and be sure to NOT include it when you complete the SECOND Usage Report.

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