The below application is the starting point for enrollment into the CPF Vaccine Discount Program; the form helps confirm your practice’s eligibility. By completing this form, the practice understands they are only starting the process and further steps will be included. There is NO FEE to join the program, however, each product manufacturer may have compliance measures in force as a trade-off for discounts below list price.

In order to complete the form, please provide information or selections for all required fields. Please be sure to select “Add Additional Providers” to include the other providers in the practice because each provider will have access to the FREE member resources, FREE education, and other FREE benefits within the site.

If you are having difficulty completing the form or if you have questions, please contact us at Michael.Hook@vumc.org.