NCIP Resources for Ordering

This resource is intended for Vaccines For Children (VFC) program participants and local schools to order needed printed materials.


You can also print directly from the examples on this form if you prefer not to wait for shipping.


Orders are placed monthly.


  • Use this form to order free immunization-related material from the North Carolina Immunization Program (NCIP).
  • Indicate the quantity of each item requested in the boxes below.
  • For items that are available in packaged quantities, indicate the number of packages you would like.
  • If not marked, the materials are available on an individual basis.
  • DO NOT PUT ZERO in a field. Skip that field if you do not need the item.


Bookmark this link for future materials order requests. Please allow 3-4 weeks for delivery.


Questions can go to Carla.Stancil@dhhs.nc.gov.


Thank you!

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**Note VAL forms are only available for VFC enrolled providers and birthing hospitals

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Sample https://immunization.dph.ncdhhs.gov/providers/ncip/pdf/vaccination_record_adult.pdf

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