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Kentucky Vaccine Accountability Section Forms

For questions about Vaccine Accountability Section forms, please call (502) 564-4478 and dial extension 4267 for Clarissa Goode, extension 4258 for Rita Lathrem or extension 4252 for Jane Payne.

VAS Forms

Private Provider and Health Department Forms

Hospital Forms

If your PIN begins with 100 or 200 use the following forms:

All Providers

The following forms are for all providers:

Return and Adjustment Forms



Last Updated 12/18/2014
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