Program Practices Submission Form

Program practices submission form - immunization program practices information
  • Immunization Program Practices Information

    Fill out and submit this form offline by downloading the form here.
  • As you want it to appear publicly
  • As you want it to appear publicly
  • All materials submitted will be posted on the AIM website.
  • Bull's-Eye Award

    The Bulls-Eye Award for Innovation and Excellence in Immunization recognizes immunization strategies that “hit their mark” and achieve immunization goals with special consideration for practices that are innovative and easily replicated. Each year, AIM awards three programs the Bull’s-Eye Award. Only those practices with activities that are currently ongoing or concluded January 2018 through the present (including implementation, follow-up, and/or evaluation activities) will be considered for the award.
  • Program Practice Information

  • Provide up to 5 main terms or phrases that describe the practice.
  • If yes, please include reference below.
  • Describe the scope of the immunization need or problem.
  • Program Practice Description

  • If "yes" or "limited" provide any data that is available
  • All materials will be posted on the AIM website
  • Upload any files to complement your submission
    Drop files here or
    Max. file size: 2 MB.
    • This field is for validation purposes and should be left unchanged.