Sanofi pasteur return form
Seasonal Flu Vaccine Return Form
preservative free, 0.5mL single dose syringe (age 3 years & up), Sanofi Pasteur 49281-0415-50 Use the last page for additional lot numbers. Please print or type legibly. Vaccine incident reason codes and instructions to complete form:
[DOC File]2017-18
https://info.5y1.org/sanofi-pasteur-return-form_1_0bc8d7.html
Sanofi Pasteur Returnability . Up to 25%, per presentation type, of doses are eligible for return. Supersedes all previous returnable programs. Returns must be in full-pack quantities only. Item No. Description Dose U/M Price** Qty. in Boxes or Vials
[DOCX File]Seasonal Flu Vaccine Return Form
https://info.5y1.org/sanofi-pasteur-return-form_1_76adb3.html
Return vaccine directly to McKesson OR as instructed by your local health jurisdiction. If you return vaccine directly to McKesson, you will receive a UPS return label from McKesson within 14 days after faxing the return form. Pack the vaccine(s) in a shipping box and include a copy of this return form …
[DOC File]2020-2021 - PBA Health
https://info.5y1.org/sanofi-pasteur-return-form_1_3dd165.html
Sanofi Pasteur Returnability . Up to 25%, per presentation type, of doses are eligible for return. Supersedes all previous returnable programs. Returns must be in full-pack quantities only. Item No. Description Dose U/M Price** Qty. in Boxes or Vials
[DOC File]Current Contract Information Form
https://info.5y1.org/sanofi-pasteur-return-form_1_f756fc.html
Sanofi Pasteur Inc. reserves the right to cancel a Member’s prebook request when a Member fails to respond to at least 2 shipping confirmation attempts made and documented by Sanofi Pasteur, Inc. Returns. Fluzone vaccine is offered on a non-returnable basis only. Members may return unused doses and receive credit for 25% of the net purchase ...
[DOC File]Seasonal Flu Vaccine Return Form - Thurston County
https://info.5y1.org/sanofi-pasteur-return-form_1_52fbdc.html
preservative free, 0.5mL single dose syringe (age 3 years & up), sanofi pasteur 49281-0013-50 Use the last page for additional lot numbers. Please print or type legibly. Vaccine incident reason codes and instructions to complete form:
Vaccine Incident Report - Georgia Department of Public Health
Once completed, return this report to the Vaccine Logistics Associate, Christy Banks, at cdbanks@dhr.state.ga.us (e-mail) or (404) 657-5736 (Fax). This report serves as a record of the incident, the steps taken to determine vaccine viability, and the disposition of the affected vaccine.
[DOC File]VARICELLA CASE INVESTIGATION
https://info.5y1.org/sanofi-pasteur-return-form_1_06839d.html
Submit the completed Withdrawal form to the Indiana State Department of Health. Following review of the form, Sanofi Pasteur will be notified of the change in Certified Provider Address and Indiana State Department of Health and Centers for Disease Control and Prevention’s listings of Certified Yellow Fever Vaccine Providers will be updated ...
New York State Academy of Family Physicians - Home
Expect loyalty to the companies in the program. Supplies Merck and Sanofi Pasteur vaccines. No cost to join or monthly fees. Requires 75% of DTaP be purchased from Sanofi Pasteur and 75% of hepatitis B be purchased from Merck. There is no cost to join or monthly membership fee. Must use Merck and Sanofi Pasteur vaccines.
[DOC File]Seasonal Flu Vaccine Return Form
https://info.5y1.org/sanofi-pasteur-return-form_1_295516.html
Vaccine Lot Number(s) NDC Number Expiration Date # of Doses Returned Return Reason # (see below) Fluzone, Pediatric dose, preservative free, 0.25mL single dose syringe (6-35 months), Sanofi Pasteur 49281-0518-25 Fluzone. 5.0mL multi dose vial (age 3 years & up), Sanofi Pasteur *Opened MDV cannot be returned, treat as wasted (reason code 3 ...
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