Enrollment

Providers interested in participating in any of California’s vaccine programs register at myCAvax to complete required training, sign provider agreements, and submit enrollment applications. For larger organizations with multiple affiliated locations, each provider site must enroll separately. All program requirements must be met before the enrollment application is approved.

Enrollment Period

VFC: Open enrollment

VFA: Closed

LHD 317: Closed

SGF: Closed

Before Enrolling

Ensure vaccine storage equipment meets program requirements.

Providers must store vaccines in vaccine storage units equipped with digital data loggers. Ultra-cold freezers are not required. Vaccine storage equipment must be set up before enrollment applications are approved.

Enroll in a regional immunization registry.

Each administration site must have a unique registry ID to enroll. AB 1797 requires provider sites to enroll in and report doses administered to CAIR or Healthy Futures/RIDE. To determine which registry to join, consult the CAIR regions map (PDF). For CAIR, see How to Enroll to get started. For the CAIR San Joaquin region, consult your Local CAIR Representative (LCR) for enrollment instructions.

Designate key practice staff to fill four required program roles.

Provider of Record (POR): The on-site physician-in-chief, medical director, or equivalent role who signs and agrees to the terms of the provider agreements and is ultimately accountable for the practice’s compliance. This role must be a licensed MD, DO, NP, PA, pharmacist, or Certified Nurse Midwife with prescription-writing privileges in California. Each site must have a provider with a valid California medical license. One provider may act as the POR for multiple sites.

Provider of Record Designee: On-site person who handles program-related matters in the absence of the Provider of Record.

Vaccine Coordinator: On-site staff (PDF) who is fully trained and responsible for implementing and overseeing the provider’s vaccine management plan.

Backup Vaccine Coordinator: On-site staff (PDF) who covers for the Vaccine Coordinator as needed.

Complete all required training before enrolling.

EZIZ offers convenient online training by program role that satisfies education requirements for enrollment.

First-time Users:  Create an account then login to start the training.

For staff assigned to multiple locations: Take required training once to satisfy requirements for enrollment.

How to Enroll

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Configure storage equipment to store vaccines

Prepare vaccine storage units (PDF) to maintain stable temperatures using DO NOT UNPLUG signage (PDF) and CDPH temperature log (PDF).
Set up storage units (PDF) to facilitate vaccine management.
Set up (PDF) primary and backup data loggers and configure settings for each vaccine storage unit.
Record storage unit temperatures (PDF) for 3-5 days to confirm stable temperatures.

Gather documents needed to complete enrollment

Completed temperature logs (three days at minimum).
Data logger temperature data files (over three days at minimum).
Pictures of vaccine storage unit interiors (must clearly show placement of vaccines, data logger probe, and water bottles/cold packs).
Pictures clearly showing entire vaccine storage unit exteriors.
Pictures of data loggers (digital displays and setup).
Pictures of “Do Not Unplug” signage placement.
Copies of certificates of calibration (primary and backup data loggers).
Completed vaccine management plan (Word).
For Federally Qualified Health Centers/Rural Health Centers: Upload a copy of license/certification or fax a copy to 877-329-9832.

Gather information needed to complete the provider profile

Names and contact information for key practice staff including providers with prescription-writing privileges who administer vaccines.
Medical license numbers and National Provider Identification (NPI) numbers.
Provider shipping address, delivery days & hours.
Names and contact information for key practice staff.
Brands/models of refrigerators and freezers storing public vaccines.
Type, serial number & calibration expiration dates (primary & backup data loggers).
Number of patients eligible for private and publicly funded vaccines to be immunized in the coming year based on previous year’s data (VFC, VFA & LHD 317 providers only).

Review provider agreements linked in the enrollment application

VFC Provider Agreement (PDF) and Provider Agreement Addendum (PDF).
VFA Provider Agreement (PDF) and Provider Agreement Addendum (PDF).
LHD 317 Provider Agreement (PDF) and Provider Agreement Addendum (PDF).
For SGF, contact your local health department

Login to myCAvax to complete the enrollment application

Have an active myCAvax account? Start here (myCAvax login required).
No active account? Start here.

Review application for accuracy then submit

The Provider of Record must review and electronically acknowledge compliance with all items outlined in any provider agreements. An email with a link to DocuSign will be sent to the Provider of Record. Enrollment is not complete until agreements have been signed.

Next Steps

CDPH will review enrollment forms for completeness and satisfaction of all requirements. Once verified, regional Field Representatives will contact providers to schedule an enrollment site visit to confirm all program requirements have been satisfied. Upon approval, Provider Identification Numbers (PIN) are assigned, which are needed to order vaccines and for all future interactions with California vaccine programs.

Linked Resources