Vaccine Wastage and Disposed Form

Form 132. Please complete this Wastage and Disposed form for any vaccine that is wasted and disposed of by vaccine providers.
This page has been automatically translated from English. MSDH has not reviewed this translation and is not responsible for any inaccuracies.

Please complete this Wastage and Disposed form for any vaccine that is wasted or disposed by vaccine providers. Every effort should be made to minimize wastage by proper handling, storage and administration.

(Amounts entered in this form must match what is being entered into MIIX.)

Last reviewed on Oct 13, 2021 request edits
Mississippi State Department of Health 570 East Woodrow Wilson Dr Jackson, MS 39216 866‑HLTHY4U Contact and information

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